Proton vs IMRT

neilm
neilm Member Posts: 65 Member
edited February 7 in Prostate Cancer #1

I know many of you have seen the results of the Partiqol study comparing IMRT to Proton. Generally the take away is that the treatments are equivalent. I agree with that assessment . I was reviewing some of the details in that study and the thing that really struck me was how good both treatments were. I personally think MRI guided SBRT is separating itself as a top technology but good old IMRT / Proton have really good track records. Sometimes when I am on support sites there are many of us with problems and it can change my view of treatment risk. This is the first time I have seen the comparative data sets and it is encouraging for intermediate patients and likely for others. Always educate yourself and advocate for the right quality treatment but if you have a moment check out this link with the study details, I find it encouraging and educational.

https://www.urotoday.com/conference-highlights/astro-2024/astro-2024-prostate-cancer/155311-astro-2024-prostate-advanced-radiation-technologies-investigating-quality-of-life-partiqol-phase-iii-randomized-clinical-trial-of-proton-therapy-vs-imrt-for-localized-prostate-cancer.html

Comments

  • Marlon
    Marlon Member Posts: 144 Member
    edited February 8 #2

    I dont understand much of the technical language, but noting that the study group was ≤ Gleason 7. It was an option for me, but I considered that it would seem to make more sense if the docs had a lot of certainty that they had identified all the locations where the cancer was active. I did not have confidence that the MRI/biopsy provided enough information on which to base that decision. As it turned out, after surgery, the situation was different than it appeared pre-surgery. I do think proton is be a top choice if I do have a recurrence and the cancer is limited to a specific location they can easily target.

  • Clevelandguy
    Clevelandguy Member Posts: 1,250 Member
    #3

    Hi,

    My first choice if my cancer returns.

    Dave 3+4

  • centralPA
    centralPA Member Posts: 363 Member
    #4

    I am always amazed at how little love brachytherapy (LDR or HDR) gets for PCa localized to the prostate since it puts the radiation right into the prostate. Right into the tumor. Any external beam process can’t match that. It frankly appears better in every possible metric (time to treat, effectiveness, quality of life, cost,…) except profit to the hospital. Tons of studies proving it.

    https://ascopubs.org/doi/10.1200/JCO.22.01856

    https://www.redjournal.org/article/S0360-3016(15)01772-1/fulltext

    https://www.sciencedirect.com/science/article/abs/pii/S1538472116305086

  • Wheel
    Wheel Member Posts: 186 Member
    #5

    except profit to the hospital. You nailed it. Many hospitals don’t even offer it anymore as less are even trained in it. It reminds me of Zevalin and Bexxar, very good radio immunotherapy proven by studies treatment for non Hodgkin’s lymphoma back in the 2000. In this case these treatments were done at hospitals not the infusion centers that the medical oncologist’s prescribed their chemo drugs and Rituxan. It was not the hospitals loss of income in this case but the medical oncologist doctors looked to lose their income streams if they referred patients for these treatments to the hospital Radiation departments and ultimately at the cost of the treatments and fewer patients being referred for the treatments led to market factors eventually having the manufacturing pharmaceuticals discontinue.

  • neilm
    neilm Member Posts: 65 Member
    #6
    https://csn.cancer.org/discussion/comment/1720843#Comment_1720843

    Good point. My only concern is finding the right doc. It seems the results can be great so long as performed by pros. That’s my only concern, but again experience is key in every treatment.

  • neilm
    neilm Member Posts: 65 Member
    #7
    https://csn.cancer.org/discussion/comment/1720841#Comment_1720841

    A lot is still evolving with Proton. Early critics were right that it is not better than IMRT. I do see it as a very accurate rifle without a scope. All the hype about the particle targeting in my book is right but there have been too many unknowns about particle behavior. Proton is now beginning the process of understanding individual patient biology ( via dual energy CT ) since what your made of can impact particle range. I think there will be a push forward in technology and accuracy. Question is does it become better than the best ? I think it has the potential to do that. Also live prostate targeting is closer in hypo fractionated delivery. Its a good therapy and I am glad all of these technologies are competing to become the best for patients.

  • Marlon
    Marlon Member Posts: 144 Member
    edited 12:13PM #8

    I am curious as to whether there is any data or experience with proton treatment as a treatment for reoccurrence after surgery. After reading the thread on radiation proctitis, I am thinking it would be a good option for that purpose. But I don't know if it is ever used for that purpose.

  • Clevelandguy
    Clevelandguy Member Posts: 1,250 Member
    #9
    https://csn.cancer.org/discussion/comment/1720898#Comment_1720898

    Hi,

    Radiation proctitis is damage produced by radiation hitting the wall of the rectum. The Proton beam particles are used to damage the DNA in the tissue to stop it from reproducing, not used to rejuvenate already dead or damaged tissue.

    Dave 3+4

  • Marlon
    Marlon Member Posts: 144 Member
    #10

    Thanks Dave 3+4 . I understand the benefit. I just haven't heard of anyone who has actually had proton treatment after surgery to know if it is being used for that purpose.

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