Prostate SBRT in NYT

Discussion in 'Radiation Oncology' started by Chartreuse Wombat, Mar 20, 2017 at 3:06 PM.

  1. SDN is made possible through member donations, sponsorships, and our volunteers. Learn about SDN's nonprofit mission.
  1. Chartreuse Wombat

    Chartreuse Wombat 2+ Year Member

    Joined:
    May 7, 2014
    Messages:
    115
    Likes Received:
    43
    Status:
    Attending Physician
  2. SDN Members don't see this ad. About the ads.
  3. Gfunk6

    Gfunk6 And to think . . . I hesitated Lifetime Donor SDN Moderator 10+ Year Member

    Joined:
    Apr 15, 2004
    Messages:
    3,305
    Likes Received:
    235
    Location:
    SF Bay Area
    Status:
    Attending Physician
    Verified
    Physician
    Verified
    PhD
    Verified
    Faculty
    Interesting article, thank you for sharing. When I was in training, the SBRT schedule we used for prostate cancer mimicked the one we used for definitive HDR monotherapy. While trials are necessary to ascertain the true answer, I don't think this type of treatment is as unproven as this article states.

    Also, prostate SBRT bends the cost curve and gives a powerful advantage > radical prostatectomy versus 5.5 - 8 weeks of fractionated XRT.
     
  4. evilbooyaa

    evilbooyaa 5+ Year Member

    Joined:
    Oct 10, 2011
    Messages:
    3,394
    Likes Received:
    1,584
    Status:
    Resident [Any Field]
    All the nay-sayers are going to say that you have to do something for 10-15 years before you could potentially even discuss it replacing standard fractionation.
     
  5. FistLength

    FistLength 2+ Year Member

    Joined:
    Apr 11, 2012
    Messages:
    154
    Likes Received:
    122
    Location:
    Dunya
    Status:
    Medical Student
    Wouldn't seed implant be even better, considering it is one and done and there is already research behind it.
     
    Gfunk6 likes this.
  6. medgator

    medgator Senior Member 10+ Year Member

    Joined:
    Sep 20, 2004
    Messages:
    2,409
    Likes Received:
    134
    Status:
    Attending Physician
    Verified
    Physician
    I don't see how that's unreasonable for something like prostate CA. Toxicity prob a bigger concern than in breast imo, plus we have better long term data for hypo fx in breast for something like skin/soft tissue reactions vs more serious bladder/rectal injury
     
    Last edited: Mar 20, 2017 at 6:02 PM
    Palex80 likes this.
  7. seper

    seper 5+ Year Member

    Joined:
    Dec 22, 2010
    Messages:
    681
    Likes Received:
    42
    what's the best paper on this (with the longest follow up I mean)?
     
  8. BobbyHeenan

    BobbyHeenan 2+ Year Member

    Joined:
    Mar 20, 2013
    Messages:
    229
    Likes Received:
    76
    Status:
    Attending Physician
    I've contemplated offering this at our cancer center, but I think I'll wait until a big phase II or III trial (RTOG or alliance, etc) open up and then participate

    The best papers I think are the Stanford experience (King is the first author I believer) with 7.25 Gy X 5. Historical older trials (SHARP) used a slightly lower dose, and as I recall had more biochemical failure than I would expect for mostly low and intermediate risk patients. UTSW used higher doses (around 10 Gy X 5 as I recall - based on HDR modeling) with good early clinical results.

    I'm not sure anyone knows an ideal dose/fractionation scheme yet, and as mentioned long term follow up is somewhat lacking. I personally don't want to do it off trial so I'll await a phase II or III that I can enroll on.
     
  9. Chartreuse Wombat

    Chartreuse Wombat 2+ Year Member

    Joined:
    May 7, 2014
    Messages:
    115
    Likes Received:
    43
    Status:
    Attending Physician
    NRG has completed a Phase II that was reported at ASTRO and should be published soon.

    NRG will soon open a randomized trial comparing 70 Gy in 28 fractions to SBRT for intermediate risk patients-Dr Ennis mentioned this in the NYT article
     
  10. seper

    seper 5+ Year Member

    Joined:
    Dec 22, 2010
    Messages:
    681
    Likes Received:
    42
    King's paper did have some worrisome side effects, as I recall.
    What's that NRG ASTRO abstract? (sorry, don't know a good way to search for ASTRO abstracts).
     
  11. Chartreuse Wombat

    Chartreuse Wombat 2+ Year Member

    Joined:
    May 7, 2014
    Messages:
    115
    Likes Received:
    43
    Status:
    Attending Physician
  12. shogun0660

    shogun0660 New Member 10+ Year Member

    Joined:
    Aug 11, 2006
    Messages:
    173
    Likes Received:
    16
    Status:
    Attending Physician
    Verified
    Physician
    Last edited: Mar 21, 2017 at 11:17 AM
    seper likes this.

About the ads

Share This Page