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Radiation Oncology • Genitourinary Cancers
How does Decipher score inform your practice for treating pelvic nodes in otherwise favorable intermediate risk prostate cancer?
Would a higher Decipher score, despite low risk for nodal disease based on MSKCC nomogram or Roach formula, encourage you to treat the pelvic lymph nodes?
Answer from: Radiation Oncologist at Academic Institution
Nodal radiation therapy in prostate cancer remains controversial. While the Decipher score correlates with lymph node involvement in pathological specimens, I have not used it to decide on pelvic nodal radiation. Two randomized studies failed to show a benefit to pelvic radiation (old studies with i...
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Answer from: Radiation Oncologist at Community Practice
There is data showing decipher is predictive for PSMA positive nodes. For UFIR, if high decipher, I consider nodal RT.
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Radiation Oncologist at Jacob E Locke MD PA
The morbidity is low for pelvic LN coverage with I...
The morbidity is low for pelvic LN coverage with I...
Radiation Oncologist at Lafayette Radiation Center
Exactly. Use it. PSMA nodal failures are not uncom...
Exactly. Use it. PSMA nodal failures are not uncom...
Radiation Oncologist at Vanderbilt-Ingram Cancer Center
Can you link this, for my own education?
Can you link this, for my own education?
Radiation Oncologist at Lafayette Radiation Center
PSMA PET Decipher risk Paper Xu et al., PMID&nb...
PSMA PET Decipher risk Paper Xu et al., PMID&nb...
Radiation Oncologist at Vanderbilt-Ingram Cancer Center
To clarify the recommendation - you get Decipher f...
To clarify the recommendation - you get Decipher f...
Radiation Oncologist at Lafayette Radiation Center
Sometimes PET UFIR. Depends on volume, percent pat...
Sometimes PET UFIR. Depends on volume, percent pat...
Answer from: Radiation Oncologist at Community Practice
It's not unreasonable to use any valid predictor in decision making. I use the Partin tables and MSK nomograms as a predictor of lymph node involvement, and if the rate is less than 10%, don't treat the nodes, and if it's 10%+, consider it. A very high decipher score indicates an increased risk of m...
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Radiation Oncologist at Dignity Health Cancer Institute at St. Joseph's Hospital and Medical Center
In cases of SBRT, could treat the nodes at the sam...
In cases of SBRT, could treat the nodes at the sam...
Answer from: Radiation Oncologist at Academic Institution
I would be hard pressed based on current evidence to consider adding LNRT to an FIR patient because of a Decipher score.
I personally go by MSKCC nomogram with a threshold of 15% and have, to date, not met an FIR patient who would meet the criteria. Some UIR patients can meet those criteria without...
Answer from: Radiation Oncologist at Community Practice
UIR with PSA<10 and a negative PSMA PET (other than prostate) with high decipher.. time to put this up on a slide and let the crowd vote....
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Radiation Oncologist at University of New Mexico School of Medicine
Enroll in the NRG-GU010 study.
Enroll in the NRG-GU010 study.