SABR treatment options

[Engraver68]

I am considering having stereotactic treatment to my single bone met in my pelvic bone, I had prostate removed in 2010 followed by radiation cycle in 2011 then Casodex until early 2018 at which point a PSMA scan identified the bone met. I am aware there are benefits to having this treatment early to delay onset of further metastasis.

Currently taking Zytega and Predniselone, and I have an injection of Zolodex every six months. I have been on this regime now for 18 months and all is stable.

As SABR treatment is not licensed in UK I will have to self fund. I am unsure whether to have this treatment with Cyberknife which will mean travelling to Royal Marsden in London or I can have it locally at Clatterbridge in Liverpool but they use Proton Beam.

Which is the preferred machine to administer this treatment?

[GP24]

Proton beam is no SBRT radiation. You need several weeks of radiation with Proton, if they are willing to radiate a single bone met at all. It is also much more expensive than SBRT.

SBRT radiation will be three to five sessions only. Plus CT, consultation etc. So staying in London for about a week for the SBRT radiation, I think is the way to go.

[6357axbz]

What’s the cost to you?

[Engraver68 in reply to 6357axbz]

Unsure I will have a better idea after meeting with consultant

[Tall_Allen]

It's usually done with X-rays, but probably can be done with protons as well. Proton is likely to be much more expensive. Extreme hypofractionation of protons is relatively new, so not every place will do it.

I'm not at all sure that it delays onset of further metastases, but if you can get it done affordably, why not try? In fact, Royal Marsden is conducting a clinical trial to determine whether it does. Unfortunately, they are no longer recruiting. However, if you look at the location list, there may be a closer facility than Royal Marsden that has the capability you need:

clinicaltrials.gov/ct2/show...

Very recent data show that the most effective local control is obtained from a single dose of 16 Gy:

pcnrv.blogspot.com/2019/08/...

[msnik in reply to Tall_Allen]

Hello Tall Allen,

Do you know what the danger is, or possibility or likelihood of damaging other organs or tissues when a single metastasis is subjected to a radiation treatment? Thanks.

[Tall_Allen in reply to msnik]

It depends where it is. I think the pelvic bone is safe, but ask your RO that question. Individual anatomy makes a difference. He does a "dose volume histogram" as part of his planning CT, so he can tell you exactly.

[Engraver68]

Thank you Tall_Allen its a bit of a shot in the dark but having had such a good response to all treatments so far and being in very good health I do think investing in this treatment is a possible help to keep things in check for a bit longer.

[j-o-h-n]

I can't answer your question but OH BOY those kids are cuteeeee. Anyone of them for sale?

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 10/12/2019 8:59 PM DST