TrueBeam radiation treatment system

ngershon

Is the TrueBeam system accurate enough for treatment if no fiducials and no hydrogel are used as my radiation oncologist recommends. I don’t think it does real time monitoring and adjusting for position changes during a session?

Clevelandguy

Hi,

It sounds like Truebeam is an X-ray based external beam. The beam even though lower in intensity than Cyberknife still goes into body tissue past the cancer. You might want to get a second opinion on the hydrogel to protect tissue and organs past the cancer site.

Dave 3+4

ngershon

thank you for advice.

centralPA

Here's the answer to this question from Google AI, "does truebeam radiation treatment of the prostate require fiducials?"

While TrueBeam radiation treatment for prostate cancer can be performed with fiducial markers, it's not always necessary. Fiducials are small markers implanted in the prostate to help with accurate targeting during treatment, but advancements in imaging technology, particularly cone-beam CT (CBCT), allow for precise targeting without them in many cases.

swl1956

TrueBeam is the model of an advanced linear accelerator made by Varian which like some other brands of accelerators is capable of different methods to apply radiation. I was treated at Fox Chase Cancer Center at Buckingham with a Trilogy accelerator also made by Varian which is considered a good machine, but the TrueBeam is supposed to be more advanced with better integrated imaging and more flexible treatment options. I believe it does make real time adjustments for patient movements. I did not have fiducial markers but did have 4 small tattooed dots placed on my abdomen used for daily alignment purposes. My Radiaton oncologist also did not recommend hydrogel. She said it was an option but indicated that with my lower daily dose of 40 treatments it wasn't statistically important and would have delayed the start of my treatments by several weeks. She also noted that although rare, there is risk involved with the hydrogel installation. So I opted out. On an anecdotal note, I would recommend staying perfectly still during your treatments no matter how sophisticated the machine is. I asked one of the radiation technicians what to do if I feel some gas building up during the treatment session. She said "Let it rip" Lols! The treatments were quite easy with the exception of the requirement of having a full bladder. Very stressful when trying to lay still and feeling like your going to pee yourself. I had a couple instances where I had to have them stop the machine so I could run to the bathroom. Sounds like you're in good hands but keep asking questions and ultimately you'll make a choice that you're sorta comfortable with.

Old Salt

It looks like SBRT (often done on a CyberKnife system) could be a reasonable alternative. If at all possible, I would look into that possibility because you don't seem 100% comfortable with the TrueBeam system.

SBRT does use fiducial markers and the SBRT specialist (radiation oncologist) may (!) recommend insertion of a 'gel' to protect the anal area. With respect to the 'gel', there is more than one option these days and whether it will be helpful depends on several patient-specific criteria. That decision is better left to the radiologist.

centralPA

My research shows cyber knife and true beam are of the same ilk, in that they enable real time tracking of the gland and thus higher accuracy. That accuracy is the key to doing SBRT, since with much fewer sessions you really can’t screw up the aim on one like you sort of can with a 40 session regimen.

So you can do SBRT with true beam.

swl1956

My understanding is that both IMRT and SBRT can be done on Truebeam. Ngershon did not say what mode of radiation treatment was recommended to him. I would think if it is SBRT due to higher gray dosage it would be more important for accuracy with fiducials and placement of hydrogel. Cyberknife has the advantage of articulated movements of its robotic arm which may not be needed in his case. I was told that Cyberknife was of no advantage in my case. They were treating a more generalized area of the pelvis to include the affected lymph nodes which the conventional linear accelerators are routinely used for.