That's a very good point and I completely agree.We are doing them all in our practice, hasn't even been a conversation about whether us or Nuc Med. There are good consults to see, as I've seen a few with large mets in the proximal femurs that I've run by Ortho and/or done a short course of EBRT while waiting for Xofigo to process/arrive. Same with spine mets, I often throw in 20/5 if bulky/threatening cord. Med Oncs and certainly Nuc Meds don't think about these local issues as we do.
It's pretty straight forward (I think). It's only approved for metastatic castrate-resistant prostate CA with symptomatic bone mets, without evidence of visceral mets (since Xofigo only has a predilection for targeting bone).how do you guys figure out use of this drug around chemo regimens?