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Radiation Oncology • Genitourinary Cancers
Would you dose escalate for prostate cancer extending to the penile bulb, towards the urethra, and close to anorectal junction?
Some loss of tissue planes after 3 months of ADT.
Answer from: Radiation Oncologist at Community Practice
I agree with Dr. @Seibert's inquiry regarding the definition of "dose escalation" in this setting. In my mind, the question relates not so much to dose as to target coverage. I would not alter dosing on this basis but would carefully assess the appropriate target with pelvic MRI and PSMA PET-CT. In ...
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Answer from: Radiation Oncologist at Academic Institution
Dose escalate above what? And is there regional or distant metastatic disease on PSMA PET?
A patient with the extent of disease described is not a good candidate for "focal" boost like FLAME because it isn't focal. The options, then, are escalation of dose to the full prostate via EBRT or bra...
Answer from: Radiation Oncologist at Academic Institution
I may be reading too far into the question regarding the potential for a single PI-RADS lesion to be in the apex region of the prostate with proximity co-planarly to both the urethra and rectum, and just superior to the penile bulb. We attempt to 'focally' boost all PI-RADS lesions called on MR...