Admin Posted October 28, 2018 Share Posted October 28, 2018 Jim Marshall (not a doctor) said ... During last Friday's phone-in meeting we discussed the latest finding from the STAMPEDE trial. Basically, men diagnosed with a few mets lived longer if they started radiotherapy at the time they started hormone therapy (ADT). Our posting on this, including links to the published paper and a news article is here: Two questions arose at the meeting: Was the radiotherapy to the prostate or to the mets? Would stereotactic radiotherapy be used? The answers seem to be: The radiotherapy was to the prostate (using high energy X-rays). Stereotactic radiotherapy is used when very precise control is needed - head, neck and near the spine. Stereotactic radiation was not used in this trial. At the meeting we spoke of the benefit of ordinary radiotherapy 'spilling' a little around the prostate, perhaps getting cells beginning to migrate away from the prostate. Indeed, if you look at the extract from the paper below, you will see that it specified the amount of spread - 8mm at the rear of the prostate, 10mm elsewhere. Radiotherapy was offered as every weekday for 4 weeks, or a higher dose one day a week for 6 weeks. It is known from other research that more, smaller doses of radiation are equivalent to fewer higher doses in effect. There is, however, a slight increase in side effects with the larger (hypofractionated) treatments. ... end Jim "External-beam radiotherapy to the prostate was given as one of two schedules nominated before randomisation: either 36 Gy in six consecutive weekly fractions of 6 Gy, or 55 Gy in 20 daily fractions of 2·75 Gy over 4 weeks. Radiotherapy was given with the patient supine and with a full bladder and an empty rectum. The planning target volume consisted of the prostate only, with an 8 mm margin posteriorly and a 10 mm margin elsewhere. Radiotherapy was to commence as soon as practicable after randomisation, and within 3–4 weeks after the last docetaxel dose." Link to comment Share on other sites More sharing options...
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