Trimodal Therapy

[Qiviut]

G9, PSA13 no met. Tolerating Zoladex ok. Start IMRT July to include pelvis and lymph nodes. Followed by LD brachy based on confirmatory TRUS. I can see no advantage to SBRT over IMRT? Clinic does not do MRI !! (Canada healthcare system). I will get privately and provide for OAR boundary definition. Dr says unnecessary but will use. Does the real-time CT scanning during RT provide sufficient definition to adjust for prostate movement and OAR movement?

[Tall_Allen]

Yes. Certainly good enough for IMRT. CTs have gotten very good, and does not show artifacts like MRI.

[Qiviut in reply to Tall_Allen]

Thanks. I am getting the MRI done for better gland definition and target planning for the brachy. Our system is short on MRI machines but I can get it done privately, for the record. TRUS is used for brachy seed placement but the MRI images will not come amiss. I realize this is all an art as well as a science.

[Tall_Allen in reply to Qiviut]

I think brachy docs sometimes don't bother with a follow-up CT within 30 days. Even with stranded seeds, I think it's important.

[Qiviut in reply to Tall_Allen]

Will follow up with my doctor.