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← Return to MRI-linac question about BCR
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Prostate Cancer | Last Active: 11 hours ago | Replies (7)
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The experienced CK doc with the latest equipment and inexperienced radiotherapists said he would do 3mm margins all around, with spaceoar and fiducials done in the OR. Dose: 36 gray to the margins and prostate and 43 to the two DIL. BCR free 75% 10yr maybe 85 with adt.
The other experienced CK with older equipment and experienced radiotherapist said 0-3mm, and 5mm other areas. fiducials done in office . no spaceoar "cuz CK is precise"
36 gray to margins and 40 to DIL. 85-90% w/o ADT 10yr bcr free rate.
The CK docs are an hour away and the unseen mrilinac ROs are 3.5hrs away.
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Well, six of one…but IMO a spacer is very important with cyberknife - this is photon - not proton - therapy so beams pass THRU the gland and could damage the rectum. They try to avoid this but why take the chance? You’re getting fiducials anyway!
As for ADT, Artera says you don’t need it; I was high volume uni-lateral G4+3 (no genetic test at that time) and my cancer came back. If it were me, I would do a 4-6 month course of Orgovyx. That 10% extra cushion may not seem like much now, but down the road you’ll kick yourself if your cancer comes back. Best,
Phil