RO meeting, SRT schedule

This morning I had my third meeting with my RO to setup my treatment schedule, assuming everything goes well with my AUS activation on Friday. I came in with a list of questions and got most of them answered.

I go in for mapping next week, get my markers and have a positioning "cushion" made. They use a Varian RapidArc machine and do a mini-scan before each treatment. The doctor reviews each scan, then the tech adjusts the machine programming as needed and then the treatment takes about ten minutes. A total of 38 treatments are planned, and will flood the pelvic floor rather than target the SV bed. No lymph node targeting is planned (11 "clean" nodes were removed during RP). He said he does not use the rectal balloon, but I was given a list of dietary do's and don'ts.

My only concern is holding 32 oz of water. My current capacity is about 500-600ml so once the AUS is activated I will need to work on stretching that out. He also said because my PSA is so low that I will likely only be on Lupron thru the end of the year. Also he said any T-level below 50 is effective (mine was 30).

So does this sound like a typical IMRT plan? I looked up the RapidArc and it appears to be a fairly new design within the past ten years.

BTW - Welcome news! My wife is having her port removed next week, several months early because it has been bothering her so much since she was declared to be in full remission, and her next scan is still three months away. Things are looking up for both of us!

Very welcome news for both you and your wife, Rob. It's about time!!

So that's 68.4 Gy? According to the following, which is far from definitive, it's a little light. MSK and UCLA are now routinely giving 72 Gy (with RapidArc). Others only give 66 Gy. With fast and accurate machines like that, a few extra Gy don't seem to make a toxicity difference, so why not give more?

/pcnrv.blogspot.com/2016/11/dose-escalation-for-salvage-radiation.html

Tall Allen said...
So that's 68.4 Gy? According to the following, which is far from definitive, it's a little light. MSK and UCLA are now routinely giving 72 Gy (with RapidArc). Others only give 66 Gy. With fast and accurate machines like that, a few extra Gy don't seem to make a toxicity difference, so why not give more?

Thanks for the link. I asked about dose and he said that would be determined after mapping.

EDIT: In my top post, I now think he said RT would flood the prostate bad, not pelvic floor.

That makes more sense.

Post Edited (RobLee) : 7/20/2017 6:12:19 AM (GMT-6)

My bladder had to be in a certain range of fullness before IMRT. The tech would doppler my bladder and have me drink more or let out a half a cup or so. Many times I was spot on and went right to the machine.