My radiation oncologist recently mentioned a clinical trial I should consider.
First some background. Gleason 3+4=7, PSA of 7.8 lead to radical prostatectomy Sept. 2020. Steady rise in PSA since surgery... 0.03, 0.05, 0.12, 0.20, 0.21, 0.22. I was referred to radiation oncology. Just got results from a Decipher Genomic test. On a scale of 0 to 1.0, i was a .56 for potential for mets - so right in the middle of their "intermediate" range of .45 to .65.
Oncologist has recommended salvage radiation and a 6 month course of ADT (Lupron) administered in two shots one at start, the second three months in. Standard plan of 39 treatments. Then he threw in a twist. There is a clinical trial which will compare hypofractionated and ultra-hypofractionated radiation. So...20 treatments vs 5 treatments, instead of the normal 39. Participants are randomly assigned to the 20 or 5. He stated the total dosing between any of the 3 options would be roughly the same - its just that they would be done in fewer sessions. From what I have read, the 20 or 5 treatments is not uncommon as primary treatment. It is not however normal practice for salvage radiation. Before I am faced with making the decision to participate or not, they will be doing a PSMA PET scan (it is scheduled about two weeks from now) - so I have a bit of time, and i am sure they will share a ton of more info on the trial. Based on what I have read of similar sounding trials, there is a thought that in the long run there may be less toxicity from the shorter duration. But most seem to focus on the added convenience and lower cost of shorter plan.
Has anyone done the shorter approach for salvage radiation? Other thoughts? I cant find anything on this specific trial but like I said, they will provide a lot more detail I am sure.