SBRT doctor questions
1.
How many have you performed?
2.
How has your practice of SBRT changed over the years?
3.
What is your 5-yr freedom from recurrence rate for patients at
my risk level? What proportion of your recurrences were local-only?
4.
What kind of urinary and rectal reactions can I expect? How
long can I expect them to last? What medications or interventions do you
typically give for that? Should I expect those symptoms to recur later?
5.
What is your rate of serious (Grade 3) adverse events? Do you
see urinary strictures? Urinary retention requiring catheterization? Fistulas?
Rectal bleeding requiring argon plasma or other interventions?
6.
What is the margin you will treat around the
prostate? Is it less on the rectal side?
7.
What is the prescribed dose to the planned target
volume?
8.
Do you work off a fused MRI/CT scan?
9.
What machine do you use (e.g., VMAT, CyberKnife,
step-and-shoot, Tomotherapy, etc.)?
·
If CyberKnife: Do you use the IRIS or a new
multileaf collimator?
·
Do you set a limit on “hot spots”?
10.
Do you use fiducials or Calypso transponders? Do
you do transperineal placement of them?
o
What system do you use for inter-fractional
tracking?
o
What system do you use for intra-fractional
tracking?
11.
In my treatment plan, what do you identify as
“organs at risk” and what dose constraints do you put on them?
o
What dose will my penile bulb receive?
12.
How long does each treatment take?
13.
How will I be immobilized during each treatment?
14.
Are there any bowel prep or dietary requirements?
15.
Should I avoid taking antioxidant supplements
during treatment?
16.
In your practice, among men who were fully potent,
what percent remained fully potent 3-5 years later?
o
Have any men retained some ability to produce
semen?
o
What is your opinion of taking Viagra
preventatively?
17.
Do you monitor side effects with the EPIC
questionnaire?
o
In your practice, what percent of men experience
acute urinary side effects?
o
In your practice, what percent of men experience
acute rectal side effects?
o
In your practice, what percent of men experience
late term urinary side effects?
o
In your practice, what percent of men experience
late term rectal side effects?
18.
What kind of PSA pattern should I expect following
treatment?
19.
What is the median PSA nadir you are seeing in
your practice, and how long does it take to reach that, on the average?
20.
In your practice, what percent of men experience biochemical
recurrence?
o
What % of those have been local?
o
If there should be a biochemical (PSA) recurrence,
what would the next steps be?
o
Have you ever used SBRT, brachy, or cryo for salvage
after a local SBRT failure, and was that focal or whole gland?
21.
Are you open to email communications between us?
