59yr, Gleason 4+3=7, PSA7.8, T2c.
Looking for radiation treatment in form of SBRT (Cyberknife) and Brachytherapy (SEED implants). Where can I find the best comparison between the two methods to ultimately decide which would be best for my case?
It seems statistically brachytherapy has best long term outcomes (lower rate of recurrence) and has been around for a long time. However, Cyberknife apparently is close in efficacy to brachy, but it hasn't been around as long to judge 15 year intervals.
Maybe there are some other moments I have to pay attention to?
________________________ 59M, Gleason 4+3, PSA7.8, T2C. DaVinci Surgery in 2021. PSA rising after surgery. What to do next? |
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I am not aware of any research comparing brachy with cyber - partly because there are two kinds of brachy for completely different circumstances and partly because cyberknife is just one brand name - there are others. Cyber et al is more closely related to EBRT / IMRT or to FLA than to brachy.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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Since you said it is irritating that I make new threads often I will post here...
M59, Gleason 4+3 (second opinion confirmed by Jonathan Epstein at John Hopkins), PSA7.8 average past 1 year, T2C stage. Haven't been operated or radiated before.
Currently am being offered:
1) 5 fraction Cyberknife (SBRT) therapy that is concentrated to the prostate.
2) 1 time high dose rate Bracytherapy combined with 5 week EBRT radiation therapy.
None of docs believe ADT is necessary as of now.
On one hand, SBRT efficacy is often compared with level of Bracyhtherapy.
It is apparently very similar in results, but I'm worried if Brachy+EBRT won't be way more effective ensuring that pelvic lymph nodes are also captured in the beam?
After all my case has a rather high recurrence rate after Radical Prostatectomy according to nonograms, however if lymph nodes are radiated, doesn't that lower the risk dramatically?
And how can Cyberknife compared in efficacy when it radiates only the prostate? There are some talks that SBRT high dose radiation is more effective in killing cancer, but it can't kill mets outside prosate, can it now? While EBRT can.
Cyberknife would be ideal solution and its close to home. Brachy+EBRT requires 5 week living in another country.
What do you think, which case would you choose in my situation?
What do you think of met risks with Cyberknife?
________________________ 59M, Gleason 4+3, PSA7.8, T2C. DaVinci Surgery in 2021. PSA rising after surgery. What to do next? |
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Where can I find most detailed comparison between brachytherapy (SEED implants) and Cyberknife (SBRT