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The non-standard cases continue to pour in. This one is a guy that had Gleason 8 prostate cancer underwent surgery in 2014 with persistent post op PSA of 0.4, then had RT to the prostate bed adjuvantly. PSA nadird at 0.6 ng/ml then started rising. He was put on some trial of abi + Lupron for a couple years. now he was taken off ADT as his PSA had been undetectable on this systemic therapy and PSA started going up fast, in November 2017 it was 0.4 now it is 1.5 ng/ml. The med onc got an auxumin PET and bone scan. There is a pelvic node in a pretty random location (attaching picture, see arrow). Does legit appear to be the only radiological area of concern. This area would have gotten RT before (im guessing something like 35-45 Gy, was done at diff hosptial). Would you offer RT for this lesion now and if so what would you give?
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