Local Ablative Radiotherapy Reverts CRPC to Earlier Disease Stage

[GP24]

The following trial was presented recently on practice update:

practiceupdate.com/c/81232/...

After radiation 73% of the 15 patients analysed had a decreased PSA value in spite of being castration resistant. 6 patients got 30 Gy in three fractions while 9 patients got 50 Gy in 25 fractions. The authors conclude: "The patients were reverted into an earlier stage of their disease again." Here are slides regarding this approach:

degro.org/ag-stereotaxie/wp...

Also, a similar result can be achieved with extended lymph node disection ( ePLND):

bmcurol.biomedcentral.com/a...

"We observed an interesting phenomenon: in patients with CRPC and BCR [biochemical recurrence], ADT can be effective again after salvage ePLND."

The authors explain these results with the following hypothesis: "we see the potential reason for the renewed ADT response as the removal of aggressive tumor cells"

[NPfisherman]

Part of my belief about stereotactic radiation--the radiation kills cells and activates the T cells to remove the damaged and dead tumor cells and by activation probably results in further reduction in tumor burden in other areas as well.......solid info...thanks for posting....

Fish

[ctflatlander in reply to NPfisherman]

Fish,

I hope your belief is true. Just had my SRS Thursday to the bone. Somewhat sore, time will tell.

Bob

[NPfisherman in reply to ctflatlander]

Since I also had this done -- one lesion, you could say I am betting my life on it...my only regret is that it was done at 6 weeks (a little early) as opposed to 8 weeks..Mine was found on axumin scan...just hoping to remain "undetectable" on my prostate specific anxiety test at end of April for now...take each day as it comes...

All the best,

Fish

[ctflatlander in reply to NPfisherman]

Fish, What do you mean done early at 6 weeks as opposed to 8 weeks? I finished IMRT to prostate, prostate bed and lymp nodes in early Feb 19. My PSA bounced up after Rad and hope it comes back down at next test. We need to start an OLIGO SRT club.

Bob

[NPfisherman in reply to ctflatlander]

Articles have said there is more benefit if on ADT for 8 weeks prior to radiation treatment...I was on only 6 weeks but so far so good...everyone is different and who knows how it will go... This disease makes me crazier...

Fish