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Decision Time ..Complete HDR or extend External Beam Radiation

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Posted 6/3/2018 2:56 PM (GMT 0)
I have completed 32 of 33 EMBRT...AND must decide now whether to

1. Complete original triple play plan by going forward with HDR or

2. Extend EXTERNAL BEAM RADIATION...for 2 weeks...easier

Based on my Gleason 8 not sure if I must go ahead with the HDR OR can choose
easier route?

A feed back appreciated
Posted 6/3/2018 4:09 PM (GMT 0)
Well, the data says that the combo approach is better for high-risk cases, such as your G8. (Also, can you expand on the percentage of G8 that you had?) What are your concerns about having the brachy part of your treatment? I wouldn't say HDR brachy is a cake walk, but it's not particularly difficult for most guys either.

I also don't know if it's just a matter of adding the two extra weeks to your IMRT. There may be more involved changes to your plan, but that's clearly a question for your RO.
Posted 6/3/2018 11:14 PM (GMT 0)
Thanks for note.
1. Gleason 8...1 sample 75 % of tissue
2. Gleason 7...4+3...3 samples ranging 15,55,65 % of tissue samples
3.Gleason 7...3+4...2 samples ranging from 50, and 70%
4. Gleason 6...3+3...1 sample 15% of sample
5. 6 samples clear

Summary 7 samples with cancer 6 clear. 53 % with.

Recent PSA came in .15 5/18

Just feel the HDR is very invasive and may not be necessary.
Posted 6/4/2018 2:19 AM (GMT 0)
You only get one shot at this...Hit it as hard as you can with everything that's available...G-8 is a different animal. You must kill it or it will kill you....
Posted 6/4/2018 2:55 AM (GMT 0)
Thanks ..read a few studies definitely seems like I must move ahead with the boost theraphy.

Best of luck.
Posted 6/4/2018 3:39 PM (GMT 0)
If I'm interpreting the study that Tall Allen posted, as a G8 the difference in biochemical progression-free survival was 83% for brachy boost vs 62% for IMRT alone.
Posted 6/4/2018 6:23 PM (GMT 0)
Couple of different research reports you can get by following the links in the report.
Basically they do show a 20 % difference. Very much in favor of Brachy Boost.
_____________________________________________________________

Age 70, diagnosed at 69
PSA 2-13-16 5.7, 5-2016 5.2, 6-2016 4.0 , Dec. 2016 5.4, MAY 2017 6.3, DEC 2017 4.6, APRIL 2018 .15
Gleason 8(4+4), three 7,s(3+4), two 7(4+3),one 6 (3+3)
Started treatment TRIPLE PLAY 12-2017 HT LUPRON, IMRT started April 2018 33 treatments completed June 2018. HDR BRACHY BOOST SCEDULED 6-14-2018
Posted 6/4/2018 7:20 PM (GMT 0)
As a new G8 (3/2018), I too have spent a lot of time investigating treatment options for my situation. When I first got the DX, I was ready to sign up for RP (as they were booking the actual surgery 2 months out) while I researched radiation options. Within a few weeks time frame, after consulting with RO, decided for me radiation was a better approach. Then came the IMRT (25 sessions) + ADT + LDR Brachy vs SBRT + ADT with Dr King (UCLA) decision. While I tried to process that decision, I started ADT (4/2018) as it was going to be used prior to either IMRT or SBRT. In the end, I couldn't find enough studies / information to show equivalence in biochemical progression-free survival for SBRT. Hence, I'm finally onboard with my decision to start IMRT 7/2018 with LDR Bachy boost to follow the IMRT.

Note that this is only my path that for me is the best choice.

Research, seek opinions, and then make ones own decision.
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