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Seeds plus IMRT, as survival benefit

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Prostate Cancer
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Posted 5/4/2018 3:11 PM (GMT 0)
Just three weeks left on my cycle of 44 radiation treatments.

Anyone opt to get brachytherapy seeds after completion of IMRT? I've read a couple of research studies that show seeds combined with IMRT (and hormone therapy) can extend survival. Are ROs amenable to adding seeds after IMRT? Thanks.



DX Dec 2017 at Age 68
PSA at DX 6.5
Biopsy: 3 of 12 pos. G5+5, 10%; G5+4, 15%; G3+5, 35%
MRI and CT no evidence of metastases
ADT Eligard, quarterly, start Feb 2018
3-27-18 start IMRT (Calypso) Virginia Hospital Center
CLL diagnosed 2015, targeted chemo 2016, two years in remission, 4-18
Posted 5/4/2018 4:26 PM (GMT 0)
The guys who've had a brachy boost will be along soon, I hope.

But It's not just a matter of completing IMRT and then having seeds put in. You've already had about 30 treatments, and may have already exceeded the external beam radiation dose that they would add the brachy boost on to. They usually give less than 50 Gy of external beam radiation with it.

ROs who are experienced at brachytherapy are usually different ROs than the ones who do external beam - it's a specialized profession. So if you want to do this, and I agree that with your diagnosis it might improve your oncological outcome, you should talk to a brachytherapist ASAP.
Posted 5/4/2018 9:05 PM (GMT 0)
I seriously doubt it. The usual dose for IMRT is 81 gy given over 45 fractions.
For combo treatment it is 45 gy of IMRT in 25 fractions and 85 gy of seeds.
Adding seeds to a full dose of IMRT is asking for trouble.
The radiation plan is developed at the start of a treatment by a physicist working with the radiologist and is determined by the tumor grade, size, location, and prostate size.

I had LDR brachy first then IMRT 6 weeks later with excellent results.
Posted 5/4/2018 9:10 PM (GMT 0)
its all in my signature except I had a couple of cores around 70%. never incontinent. can have sex. with a combination treatment you can deliver more radiation to the prostate and surrounding area but this is all calculated before treatment.
Posted 5/5/2018 11:31 AM (GMT 0)
As John T said, this has to be planned before the radiation treatment began so it isn’t now an option. It would likely be pretty toxic given the amount of external beam radiation you have received. Should you have a local recurrence, you may still be a candidate for HDRBT but not permanent seeds.
Posted 5/7/2018 8:26 PM (GMT 0)
Thanks, guys, I did talk to my RO. He said absolutely no seeds for me.
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