Higher dose improves results in high-risk patients (no surprise)

[Tall_Allen]

This trial began 15 years ago, and the results are irrelevant to how patients are currently treated. But it's always nice to get Level 1 evidence, even if it only confirms what we already know.

prostatecancer.news/2024/01...

[Jimbo59]

Makes me wonder if the 55 Gy I received 8 years ago in 20 fractions was optimal. No ADT. It was however for adjuvant treatment for a 3+4 tertiary 5 case with established EPE and PNI as only adverse pathology. Would probably opt for early SRT if I could wind the clock back. No recurrence to date thankfully.

[Tall_Allen in reply to Jimbo59]

Yes, that's optimal dosing for adjuvant/salvage radiation.

[Cactus297]

Hi TA,

I want to make sure that I understand the facts correctly.My son is taking Lupron, generic Zytiga and prednisone and was given six weeks of IMRT a year ago March of last year. He is high risk tertiary five and it had spread as far as some pelvic lymph nodes but not further . He goes for a checked up January 29 but thus far his PSA and bloodwork have been OK..

The new SOC is taking three years of Lupron not two years right? He seems under the impression it’s two years, but I read three years..which is correct? He has just started his second year.

Thank you very much.

[gsun in reply to Cactus297]

I believe he said the three years was what they used 15 years ago but today probably two years is what is used. I haven't seen three years lately.

[Cactus297 in reply to gsun]

As far as Lupron is concerned, I read the study and the recommendation is three years.

I believe it was two years prior to the newest study. I would like my son to stay on it three years.

[Tall_Allen in reply to Cactus297]

3 years of Lupron and 2 years of Zytiga for positive nodes.

[Cactus297]

My son told me that he is scheduled to come off at the end of two years and I told him he needs to stay on Lupron three years per the new SOC study you posted. Maybe I’m getting it wrong and that his new MO at the Mayo was referring to the Zytiga not the Lupron. I hope so. When the time comes if she wants to take him off Lupron I will push for a second opinion from his previous MO at UCSD. We have another almost 12 months before that happens.

He is going to the Mayo tomorrow to have his Lupron injection and have the blood work checked. Since the IMRT last March his PSA and bloodwork have been OK. I am hoping that our luck will continue tomorrow.🤞🙏🏻🍀for him and everyone else on our Forum.

[Tall_Allen in reply to Cactus297]

I think Rana McKay at UCSD is excellent. So is Oliver Sartor at Mayo.

[Cactus297 in reply to Tall_Allen]

Dr. McKay was his original MO at UCSD and he has a woman MO at Mayo but I will tell him about Dr. Sartor. For the life of me, I can’t remember his doctors name at Mayo. He went to Mayo today for his three month check up and his PSA stayed the same as three months ago < 0.10. I don’t know about the testosterone as he didn’t send that to me if they took it.. he seemed a bit evasive tonight. I hope he is not hiding something from me and I’m just reading too much into it.Do they usually take the testosterone every three months too?

Thanks!

[Cactus297]

I didn’t realize that the trial began 15 years ago. Thanks!

[garyjp9]

I had 39 fractions and 70 Gys for N1 disease in 2021, following an RP, along with Lupron and Zytiga. Docs said that was the SOC protocol at the time. So, is there now be a new SOC of 80 Gys for the RT component?

[Tall_Allen in reply to garyjp9]

Salvage is different from primary radiation.

[garyjp9 in reply to Tall_Allen]

Thanks, TA