SBRT or IMRT

[Klunacat]

trying to make big decision

Any insight, thoughts or experiences appreciated.

My husband has denovo oliogometastic pc.

Diagnosed may 22

Psa 155

Lymph nodes and one hip bone spot

Triplet therapy began june 22 - Zytiga, prednisone, firmagon and taxatere for six cycles - responded well - still on zytiga, prednisone and firmagon

RARP November 22 - 4 of 16 positive nodes .4 margin at bladder neck

Next up is Radiation

We received two conflicting opinions

Dr. Phillips at Mayo

Wants to do 6 weeks of IMRT to prostate bed, pelvic node chain and bone spot

Dr. Nagar at weill cornell

Wants to do 5 days of SBRT

25 grays to pelvic nodes

40 grays to bone spot

No radiation to prostate bed at this time. - wait and see approach- minimize toxicity to bladder

We don’t know which to choose!

Is high dose SBRT too toxic?

Or is it more aggressive and more likely to be successful?

Is leaving the prostate bed out a bad or good idea?

Does sbrt have more side effects?

Why would Mayo choose IMRT if SBRT is better?

does anyone know of any studies that might help us decide?

Thank you

[Hidden]

I’d go Mayo with imrt . Because it worked for me ! Good luck !

[Klunacat in reply to Hidden]

Thanks

Was your radiation after surgery and with mets at diagnosis?

How long ago was it?

[Hidden in reply to Klunacat]

I was T- 4 which in my case meant that pc tumors exploded out of the prostate into the urethra and bladder , non op . “ The horse was out of the barn” I was told by my uro that dxed me in 2015 ….Then after double adt and imrt I went under the radar and have stayed there over seven years so far .

[j-o-h-n in reply to Hidden]

AHTISSUE! - God Bless you..... (hint)

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 02/28/2023 9:38 PM EST

[Hidden in reply to j-o-h-n]

ty

[Hidden in reply to j-o-h-n]

gazuntight!

[j-o-h-n in reply to Hidden]

Thank you, and thanks for the Scott tissue.........

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 03/01/2023 1:54 PM EST

[Hidden in reply to j-o-h-n]

No ! Thank You ! U da man! ❤️

[Klunacat in reply to Hidden]

thanks for sharing. Thats great for you!

[Hidden in reply to Klunacat]

I’m far from trouble free but I’m still here . Ty

[StephH72]

If there are studies out there that will help you decide then maybe Tall_Allen would know where to look?

[Tall_Allen]

Sparing the bladder is a good idea, because there is no known benefit to doing this. IMRT or SBRT doesn't matter.