HealingWell
Search Close Search
☰

Hypo fractionated boost

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 9/2/2018 9:00 PM (GMT 0)
Has anyone had a hypo fractional boost by SBRT along with traditional EBRT and HT. I’ve been offered that at BCM in Houston versus traditional IMRT/VMAT and ADT by my local RO.
Posted 9/2/2018 9:22 PM (GMT 0)
It's been the subject of some experimental clinical trials. Here's an article about it:

/pcnrv.blogspot.com/2016/08/sbrt-boost-therapy.html

My question is this: what is the advantage of just boosting the prostate dose with SBRT -- Why not treat the entire area with SBRT and do it in just 5 treatments?

You are intermediate risk, right? SBRT monotherapy has very good cure rates with low toxicity in intermediate risk patients. Adding ADT has never been shown to improve outcomes.

Interestingly, MSKCC is running a "reverse" trial for intermediate risk patients - SBRT over the wider area and a brachytherapy boost to the prostate. I really don't see the point of that either.
Posted 9/2/2018 10:03 PM (GMT 0)
I can see the point ... Money.... These doctors are all businessmen or they work for profit driven corporations...So it's very hard to find a treatment center that favors a treatment that costs less money..When it's proven that a 5 dose treatment works just as well as a 40 dose treatment, getting the "industry" to adopt the far less expensive 5 dose protocol will be an uphill battle..Before they finish up with you, they are gong to bill somebody $100,000, $150,000 . That's how the system works...
Posted 9/3/2018 3:43 PM (GMT 0)
I had 26 treatments - Hypo fractioned of IM/IGRT while taking Bilcalutimide (Casodex)for six months! I know it is bit different from your question but the Hypo fractioned treatment in conjunction with HT/ADT seems to be MSKCC protocol for lower risk patients! yeah

Also Fairwind, I am not sure if I 100% agree with your assessment. Your broad statement about the entire industry does not represent the opinions of all hospitals and RO's. My RO was always looking for 5 treatments and only used 26 treatment - IMRT due to my enlarged prostate. My RO does SBRT 90+% of the time unless there are over variables that prevent him from using this RT!
Posted 9/3/2018 4:21 PM (GMT 0)
Interested in TA's comment re SBRT vs. IMRT. Had a RALP (5/18 Tewari). He has an Oncology group that includes RO Richard Stock. I'm seeing him in a couple of weeks. I know they're going to recommend IMRT to pelvis. I had asked about SBRT when I first met with him briefly and he said that the pelvic area was too large for SBRT. I'll ask more questions, but I speculate that there's cancer there that is not large enough to image.

Interestingly I asked my ONC, who is nationally known and highly regarded, whether I should get SBRT to metastases. He said "no". I said "why?". He said "you have more than three metastases". I said: "who came up with that number?". He said "well, it is a bit arbitrary". He actually referred me to stock and said "see if he'll do it".

Another example of being your own advocate. Here's a world class ONC who says "no". Just keep asking questions. Like Why IMRT instead of SBRT >
Posted 9/3/2018 5:23 PM (GMT 0)
ANB-
I was commenting on hypofractionated IMRT used for primary therapy, not salvage - a different animal. There are clinical trials for hypofractionation and SBRT for salvage RT, but it is still experimental.

There is no proof that SBRT to mets increases survival, but if it is safe to do so, why not? It can relieve pain and reduce fracture risk in weight-bearing bones.
Posted 9/3/2018 11:44 PM (GMT 0)

BangedUp said...
Has anyone had a hypo fractional boost by SBRT along with traditional EBRT and HT. I’ve been offered that at BCM in Houston versus traditional IMRT/VMAT and ADT by my local RO.

I was high-risk and treated along those lines (see my signature).
✚ New Topic ✚ Reply