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Topics:
Radiation Oncology • Genitourinary Cancers
Would you consider prostate SBRT in a patient with focal extracapsular extension?
Answer from: Radiation Oncologist at Community Practice
Most of the time, the concern for ECE is based on MRI findings. Some of the time the concern for ECE is based on broad capsular contact or irregularity of the capsule. Previous studies have demonstrated that the distance of actual microscopic ECE is 5 mm or less. So suspected ECE or early ECE is inc...
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Answer from: Radiation Oncologist at Community Practice
20-50% of all prostate cancer patients have ECE (stage T3a), whether it is visible on imaging or not, depending on their risk group classification. RP surgical pathology literature clearly indicates that the typical distance of ECE beyond the prostate is 1-5 mm. I agree with @Irving D. Kaplan, in th...
Answer from: Radiation Oncologist at Academic Institution
No.
Answer from: Radiation Oncologist at Community Practice
It gets tricky, so I'd rather do hypofractionate by IMRT, 70Gy in 28 fractions: safe, short, and effective.