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Please share your salvage radiation experience, especially on VMAT

Posted by prettypass2000 @prettypass2000, Mar 21 9:00am

I posted several weeks ago about my husband's prostate cancer recurrence on one PSMA-Positive lymph node almost 5 years post prostatectomy. After meeting three different radiation oncologists in Germany, he finally chose his treatments and got pre-authorization approved from our health insurance yesterday. Here is the recommended plan:

"1. Initiation of antihormonal therapy for at least 6 months (relugolix)
2. Salvage radiotherapy using image-guided intensity-modulated therapy (VMAT/IGRT)
of the prostatic bed and the local and regional lymphatic drainage pathways up to 50.0 Gy (ED 2.0 Gy)
as well as a simultaneously integrated boost (SIB) to a PET-suspected lymph node with
57.5 Gy (ED 2.3 Gy) or an SIB to the prostate with 62.5 Gy (ED 2.5 Gy).
A total of 25 fractions are planned."

Has anyone had experienced with 25-28 sessions of moderate-hypofractionation radiation with VMAT/IMRT? If you do, could you please share your experience with us? We very appreciate any information you all can give us. What should we know or ask at the CT planning/mapping? What are side effects - both short-term and long-term that you have experienced? Thank you in advance.

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heavyphil | @heavyphil | Mar 22 9:46am

Hello, I had 25 sessions of hypofractionated treatment to prostate bed and pelvic nodes - total 10,500gy. However, no isolated metastases were treated.
Also did 6 months Orgovyx. His treatment is almost identical to mine and I had no problems (except for the bowel challenge!).
That said, we are all truly different and his side effects could vary from zero to severe - and no one can predict what they will be.
Hopefully, he will be in the vast majority with minimal short term SE’s and nothing more.
Phil

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prettypass2000 | @prettypass2000 | Mar 22 10:42am
In reply to @heavyphil "Hello, I had 25 sessions of hypofractionated treatment to prostate bed and pelvic nodes - total..." + (show)
Profile picture for heavyphil @heavyphil

Hello, I had 25 sessions of hypofractionated treatment to prostate bed and pelvic nodes - total 10,500gy. However, no isolated metastases were treated.
Also did 6 months Orgovyx. His treatment is almost identical to mine and I had no problems (except for the bowel challenge!).
That said, we are all truly different and his side effects could vary from zero to severe - and no one can predict what they will be.
Hopefully, he will be in the vast majority with minimal short term SE’s and nothing more.
Phil

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@heavyphil Thank you so much. He has one PSMA-positive lymph node, so they decided to do SIB on it simultaneously with the radiation. I have done some research on side effects so that I am aware of them. I hope he’ll tolerate the side effects well.

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