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SBRT and PSMA

Watch the webinar: The Role of Specific PET PSMA imaging and SBRT in the Management of Prostate Cancer

Thank you  Dr. Jeremie Calais, Dr. Stefan Korber and Dr. Kai Schubert for your instructive presentations!  Did you miss the webinar? Watch the recording In addition to all questions answered at the end of this webinar, here are a few remaining ones, which the speakers kindly answered: Do you think that PET imaging in treatment position needs to be done systematically (in order to decrease irradiation dose exposure) ? Dr Calais: No. This is not like head and Neck or lung. Rectal and bladder filling are too complex to really have exact repositioning from PSMA PET to treatment table. Dr Schubert: Treatment position is not absolutely necessary, of course favorable. Different positions between treatment planning CT and ‘diagnostic’ imaging can be taken care of by deformable image registration, but there are limitations and additional QA would be necessary.   Is there any comparison between PSMA-Targeted therapy and SBRT?  Dr Calais :  No (not yet). Trials of PSMA MRT for oligometastatic disease are underway. My personal opinion is that it may not be the best application as a single agent therapy because the local control is inferior than with SBRT. However it can treat the microscopic and small lesions, so maybe the combination of both is probably a good approach.   When should we re-image after PSMA guided MDT? after changes in PSA? Dr Calais : At least 4 months after the end of SBRT ( for the local control).Otherwise if suspicion of new lesions based on PSA rise after NADIR or other imaging suspicion or clinical symptom. Dr Korber: I think, checking the PSA is adequate. Sure, if the PSA is rising again, new imaging (e.g. another PSMA-PET/CT) should be evaluated.
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