SBRT fiducials

[twoodogs]

Do most RO's use fiducials for SBRT or is there another way for them to see the prostate? Is the barrier gel commonly used also?

[Jpl506]

If the linac is MRI guided fiducials aren’t needed.

[Tall_Allen]

I haven't seen a trial of Barrigel vs fiducial precision. It's a good question to ask an RO who does SBRT.

[ToolBeltZia]

I had SBRT, fiducials and Barrigel. Treatment was a piece of cake, and so far (6 moths later) no side effects.

[Scooter22 in reply to ToolBeltZia]

Same here

[LBRV711]

I had SBRT CyberKnife with fiducials and Space Oar 5 months ago at NYU Langone. Fiducial procedure and space oar were done together by my urologist under a local anesthesia, and was easy and painless. SBRT was only five sessions with my RO, was painless with a few days of frequent runs to the bathroom to urinate and that was it. Very pleased with entire procedure and present outcome.

[Scooter22 in reply to LBRV711]

Same here

[janebob99]

I had three tiny tattoo marks on my belly for fiducials, and SpaceOAR rectal spacer installed. I start SBRT on July 2. The SpaceOAR install was somewhat uncomfortable, but not as bad as a Biopsy.

[PT49]

11 months ago I had SBRT (5 treatments) with a Varian TrueBeam and no SpaceOAR with a 6 month shot of Lupron. Only had two tattoo dots (one on each hip) for alignment. Only side affect was several days of urinary urgency. Other then that I didn't even know I had any radiation treatments. PSA to-date is less than 0.04 and Testosterone level at 400.

[northshoreguy]

I had sbrt with fiducials in August of 2021 with 23 months of lupron then Eligard then the final 12 months with orgovyx. I had excellent results until 4/24 when my psa increased to. 06 Waiting for my next appointment to see if the psa keeps increasing. Fingers crossed.

[Cooolone]

Why not use them if they assist in targeting? Radiation toxicity is real (go ahead and ask me)... Sometimes it can be acute, within months but goes away, or worse, latent when it doesn't show for 18 months or later post therapy. Let alone multiple therapy regarding Radiation. I've had IMRT (40) in 2019 and SBRT (13) late 2022, and lately have identified some issues.

Crazy cause I woulda never thought it would happen as all went very well both times (different targets).

So my suggestion is to do your homework, as gel isn't always useful, but there are some things that can help reduce toxicity potential. Lol, one being getting to the very best of the best to do the work! I have and did, and still... So I couldn't imagine going to the local hack, lol.

Good Luck

[lpol83712]

MRI directed treatment as I received at UCLA does not need them. With MRI directed the prostate is easily seen which isn’t true with CT directed and reason wit CT guidance you need fiducials

[Teegolf47]

Just finished MRI SBRT at City of Hope on Friday 6/21 and they did not use any spacer or fiducials. I read that only 44% of patients in Dr Kishan’s MRI guided SBRT Clinical Trial had spacers. None of the patients in the MRI arm received fiducials.

Terry