At 5 years, this looks good for high-risk men. I hope it holds up.
Dose Painting: simultaneous integrate... - Prostate Cancer N...
Dose Painting: simultaneous integrated boost (SIB) to the dominant intraprostatic lesion (DIL)
Written by
Tall_Allen
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The RO recommends SIB as part of my treatment. PSA was 19.76 (4/2023), then 21.78 (5/2023 to confirm initial PSA). He is concerned that the PSA does not match the Gleason score as PSA is greater than 20 but Gleason score is only 7 (grade 3). He said it could indicate microscopic disease outside of the prostate that was not detectable on PSMA PET, so he ordered another PSA (currently 19.39). He recommends IMRT to target prostate, seminal vesicles and low pelvic lymph nodes (flame protocol). 37 fractions, 70-78 Gray to prostate and SIB boost to 85-90 Gray. Any thoughts?
Looks good to me.
Thank you. I take it this protocol is not terribly common? After reading the study you provided in your original post, it appears to be effective. I guess I didn't realize how advanced my disease could really be and grateful the RO has expressed his concern of the disconnect between psa and Gleason score.
