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PAMY had a question on Proton Therapy -

Tim6003's picture
Posts: 1511
Joined: Nov 2011

Hey all....looks like Pamy posted a quetion on an old thread by Sam999...so I am reposting here for her.  Question below..



Hi John-

Just researching treatment options and wondered if you had Proton vs IMRT. Although they have not confirmed it improves outcomes, I believe they have proven it reduces some of the awful 'after treatment is over' permanent side effects, namely dry mouth and damage to teeth. Can you give me your opinion on this, please? Since you are one year out, are you able to tell me if you are back to your 'old normal' or are you left with any problems?

Thank you so very much.



corleone's picture
Posts: 264
Joined: Jul 2012

I had the “classical” (by now) IMRT technique for my NPC. I wanted the proton beam instead, because it definitely has fewer side effects, but: 

It was not available at that center; 

More expensive, where available; 

There is no proved improvement in survivability; 

It has a major drawback, it is “too” precise, and the beam does not travel all the way through the body. While this looks an advantage, it’s not always the case, as the radiation should cover all or extended regions, (even if with lower doses), “just in case”. I don’t necessarily agree with this, but that’s the explanation I was offered.

Personally, I consider the proton beam superior, but since it was not available, it made things easier.


Skiffin16's picture
Posts: 8286
Joined: Sep 2009

LOL, I was never normal to begin with, and certainly not now... I lean toward the Abi-Normal ....

I am actually nearly four years post Tx... I have probably 98 - 100% of my taste back, and around 90 - 95% of saliva... only trying out at night.

I have all of my teeth that I had going into treatment, other than two crowns, which isn't uncommon for me even before treatment.

So for me, IMRT wokred well I'd have to say...

Thyroid took a hit, and more than likely going to need to go on Synthroid in the near future..., but that should be an easy fix.




donfoo's picture
Posts: 1644
Joined: Dec 2012


I am waist deep in the same topic -- various radiation technologies being used these days. Next week, I start radiation on a Varian Trilogy RapidArc linear accellerator, apparently the newest generation of IMRT machines available. From the description below, the Eclipse treatment planning tools can create plans for all forms of therapies including proton. Tomorrow I am meeting with my RO toi go over the planning and design of my program and the various decisions surrounding what type of beam they selected and why, etc. I am really pleased that the latest technology has such great ability to target the main tumor mass while contouring via 3D and minimizing having rads thrown onto non-tumor areas including parotid, salivary, and thyroid areas.

All In One. Best In One.

Varian offers the complete package in Trilogy:

  • Choose from a broad range of external beam therapies, including 3D CRT, IMRT, IGRT or DART using the Trilogy system.
  • Multiple dose rate options – up to 1000mu/min for efficient SRS delivery.
  • 2D and 3D KV image guidance for higher quality imaging at lower doses.
  • Full 360° range of treatment delivery angles with positional couch angles.
  • Stereotactic frame or frameless immobilization for patient positioning - treat any area of the body.
  • Real-time Position Management™ (RPM) system - for gating perfectly timed beam delivery with minimal margins.
  • Gated RapidArc with advanced motion management and open third-party interface.
  • Portal Dosimetry IMRT treatment delivery verification.
  • Dynamic high resolution MLC for exquisite beam sculpting.
  • Delivery verification and quality assurance in Argus Linac and Argus IMRT quality assurance software.

Clinical benefits:

  • Highest dose rate for shorter sessions.
  • Faster treatment times.
  • Tight isocenter alignments on all three axes. Targets the smallest lesions.
  • Rapid on-board imaging. Reposition patients quickly and accurately.
  • Cone-Beam CT, fine tune patient set ups with ultra-precise CT scans.
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