PSA bounce after SBRT for bone metastasis
Interesting case.
Patient with metastatic prostate cancer (several bone mets after prostatectomy and adjuvant RT).
He started ADT over 3 years ago and got up-front 6 cycles of Docetaxel. PSA dropped to around 1.5 ng/ml, remained stable for almost 2 years and rose this winter to 2.5 ng/ml.
Whole-body MRI showed a viable lesion in the spine, the rest of the lesions seemed stable. We had done yearly wbMRI, so it was rather easy to pick up.
I SBRTed the lesion and measured the PSA immediately...
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Source: Student Doctor Network - May 24, 2022 Category: Universities & Medical Training Authors: Palex80 Tags: Radiation Oncology Source Type: forums
Understated Risk of Radiation induced Malignancy?
Dropping this hear to poke the bear/stir up some discussion
https://ascopubs.org/doi/full/10.1200/JCO.21.00596
RCT of adding docetaxel to RT+ADT for unfavorable intermediate risk disease. No difference in OS with adding docetaxel. But more concerning is the fact that they found a 4.6% incidence of radiation induced cancer (rectal or bladder) at 10 years of follow up. That I find highly concerning, I had quoted my patients likely a 1% risk.
Sample size isn't huge, so luck could play...
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Source: Student Doctor Network - July 23, 2021 Category: Universities & Medical Training Authors: DoctwoB Tags: Radiation Oncology Source Type: forums
No Taxols in Breast ?
Okay.
What's the trend ?
Breast Cancer = Pacli/Docetaxel ?
When do you skip Pacli/Docetaxel in Breast cancer ?
I have a patient with T2N0M0 - Post MRM in a 50/F post menopausal with a Ki67 of 30% !
I wanted to do a 6xFEC - but seems this 'taxol is the thing' is pushing me hard to put her on 3xT after 3xFEC.
What's your opinion ? (Source: Student Doctor Network)
Source: Student Doctor Network - July 6, 2017 Category: Universities & Medical Training Authors: abish Source Type: forums
