How would you approach an isolated Axumin PET-positive focus in the prostate bed in the setting of rising PSA after prostatectomy and salvage radiation?
Would you consider reirradiation, including SBRT?
Answer from: Radiation Oncologist at Academic Institution
In general, I do not offer reirradiation to the prostate bed following salvage radiation therapy, as the risk of causing significant late toxicity affecting the rectum, bladder and tissues of the pelvic floor is high if one were to try to deliver a dose that had a reasonable chance of achieving long...
Answer from: Radiation Oncologist at Academic Institution
I have been referred a handful of cases with this description, and all but one instance turned out to be false positives when evaluated on MRI. Prior to considering any local salvage therapy, I would require biopsy confirmation. In the one patient who I have seen with actual biopsy-confirmed prostat...
Answer from: Radiation Oncologist at Community Practice
In the rare instance where reirradiation could possibly be delivered without exceeding tolerance of the bladder and rectum, I would consider what the likelihood was that the patient really only had a local recurrence (despite what the Axumin scan shows). Thus, I would take into consideration factors...
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