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Topics:
Radiation Oncology • Genitourinary Cancers
Do you time initiation of definitive radiation on PSA response to neoadjuvant ADT?
Is there any benefit to delaying start of RT or perhaps changing to complete adrogen blockage if maximal PSA response is not achieved in 2 mo?
What PSA metric are you using, for example, <0.3, <0.1, other?
Do you feel PSA reponse to ADT is a surrogate for less agressive disease or does allowing a more robust PSA repsone actually result in "more" radiosensitization and potentially better outcome?
Answer from: Radiation Oncologist at Academic Institution
In the setting of definitive RT, I will generally wait 2-3 months before beginning radiation for 2 reasons. First, during that period of time the prostate may shrink by as much as a third of it's original size, which may adversely impact on the normal tissue dosimetry if this were to occur during th...
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Answer from: Radiation Oncologist at Community Practice
I would agree with @Mitchell S. Anscher in regard to timing. Practically speaking, in the US most RTOG studies started 2 months prior to RT. In Canada and Australia this could have been 6 or 8 months prior to RT, and in EORTC at the same time as RT. Nevertheless, 2-3 months is useful for volume...