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MSK Nomograph-- strange results-- also GY SRT query

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Posted 1/8/2011 4:12 PM (GMT 0)
For those who have undergone SRT, how many GY did they use?

When I try the MSK nomograph

http://www.mskcc.org/applications/nomograms/prostate/SalvageRadiationTherapy.aspx

for SRT, I get interesting results.

My numbers are: 4.19 PSA

G 4+3

Surg. margins positive'

ECE--YES

Pre-radiotherapy PSA 0.21 (estimate)

PSA doubling time: 3 months

Months disease free: 13

GY: 78

I get a 36% roughly probability of 6 -year progression free survival

If I change the GY to 66, it goes up to 52%!!!

If I lower it, it then goes down.

If I go to 72, then the prob. is 45%.

Isn't that very strange? I thought the higher the GY was, the better chance you had (with more SE).

So, what is the standard GY dose for SRT?

Mel

Posted 1/8/2011 4:20 PM (GMT 0)
Mel,
This was discussed a while back. What happens in certain situations in the nomograms is that the sample size for that particular set of stats is too low and one abberation can influence the result. In just about 100% of the time a higher dose will equate to a higher cure rate, not a lower one.
JohnT
Posted 1/8/2011 4:44 PM (GMT 0)
Mine plans to do 66GY's over 7 1/2 weeks..
Posted 1/8/2011 6:24 PM (GMT 0)
John:

The question is: which one is the aberration?

I suspect the 78gy is, since most of the lower ones result in similar probabilities.

Still... supposedly they are dealing with so many cases...

Mel

Posted 1/8/2011 7:13 PM (GMT 0)
Hi Mel
I did a total of 68 gy. I am sorry you have to even make any kind of decision on this.
Mine is working well so far as I got another <0.04 for my Dec. psa which was @ the 2 year mark.

I also have a good friend who finished his SRT in Nov. He just got his 1st reading which was 0.3, but he started SRT with over 0.50, so he is happy it is going in the right direction. His surgery was 9 years ago by Dr. William J. Catalona

Good luck with all this!!

David
Posted 1/8/2011 9:16 PM (GMT 0)
Mel, mine was 70Gy delivered over 35 treatments.

Don't know about the nomo numbers. Tried using the thing a few times and figured stats are stats. Didn't like what the danged thing had to say anyway. And I have personally blown away the success stats of one of the top five daVinci dudes in the country.

Every day there is a post here that continues to show that every single PCa case is different and responds different.

Just look at my stats. never got low PSA after surgery. MET discovered only 8 months following surgery and and 3 months following SRT. Now my PSA is 3.9 and I feel better than I have in the last two years. Peeing like a 20 yr old, ED is showing real strong signs of improvement and my energy level and enthusiasm for doing things is off the chart.

I promise I am not sticking my head in the sand about the seriousness of this thing, but I just can't seem to keep wasting anymore energy on it.

Bless you my brother and I hope things work out real well for you.

Sonny
Posted 1/8/2011 9:41 PM (GMT 0)

Sonny:

You and I had the same surgeon, so we are both blowing away his stats!

Mel

Posted 1/8/2011 9:47 PM (GMT 0)
Mel:

I was given 72 gys spread over 39 treatments. They had considered 80, which is huge for SRT, so glad they didnt, as the 72 did so much perm. damage to me.

david
Posted 1/8/2011 10:07 PM (GMT 0)
Mine was 70 gys over 39 treatments. Squid.
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