Clinical trial for treatment of PCa bone mets by SBRT

[Break60]

Does anyone know of a Clinical trial for bone mets outside of the spine after having RP, SRT to bed and RT to lymph nodes as well as ADT? I had a axumin scan which found 9mm lesion on right femur.

Bob

[AlanMeyer]

What did the people who administered the scan say? Did they recommend radiation? Surgery? Nothing?

I don't know about clinical trials, but I know that the Mayo Clinic will do radiation or surgery if a single met can be found and they have reason to believe there are no others. I think Dr. Kwan is the head of their unit that scans for "oligometastatic" lesions and then treats them.

Alan

[Break60 in reply to AlanMeyer]

Scanners are just scanners. My RO put me back on ADT and recommended imrt. I don't want to take that long so I'm seeking SBRT.

[BigRich]

Break60

What was the total Greys or Gy to the lymph nodes only? Was It SRT Or IMRT or Proton beam radiation?

Rich

[Break60]

Rich

In September 2015 MRI found two hot iliac lymph nodes so I had IMRT to all pelvic lymph nodes comprising 75 greys in 50 fractions. Prior to that in June 2014 I had SRT to prostate bed of 68.2 grays in 38 fractions by IMRT after recurrence post RP which I had in September 2013. There's been no recurrence in those areas or anywhere else except right femur found last week by axumin CT PET scan after I ceased ADT3 in November 2016. I'm back on ADT3 since I'm apparently not castrate refractory yet. This is my first met to bone.

Bob

[RetiredGuy]

Here are two clinical trials for oligometastatic bone mets using SBRT, one for mets which appear at initial diagnosis, the other for mets that appear later. Both are in Pittsburgh. I was in the first one, with moderate success. Not clear if you already have mets in your spine, in that case it may depend on how many and how long you've had them. Might be worth contacting them.

clinicaltrials.gov/ct2/show...

clinicaltrials.gov/ct2/show...

DCM

[Break60 in reply to RetiredGuy]

Retiredguy

Thanks. How are you defining " moderate success"? The only bone met found via axumin scan was in right femur. What's the advantage of getting treated in a clinical trial vs. just getting SBRT to the met wherever it's done?

Thanks

Bob

[RetiredGuy]

Hi Bob--I had 3 mets in my pelvis which were radiated and had undetectable PSA for about a year. After about six months, PET scan showed a spot in my left femur, which was radiated successfully. I didn't discover the clinical trial until a year had passed--I think I may have had a better result if I had been treated closer in time to my diagnosis. As to clinical trial vs. regular treatment, I can't say without knowing outcomes in both cases. I went with the trial because at that time (2013) it was the only option for treating oligometastatic disease w/ SBRT.

[Break60 in reply to RetiredGuy]

Got it. I talked to a local RO today who said he could use SBRT , 3 fractions. It would be " a chip shot" because it's in a spot not near vital organs. But he did agree that I should be on ADT due to my fast doubling time and bad pathology.

Bob

[George71]

what is the difference between SBRT and IMRT

[Break60 in reply to George71]

Sbrt is much higher dose than IMRT so very few sessions are needed. It’s used for spot radiation in areas of the body not located near other organs which need to be avoided and where the area to be radiated is small .