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Radiation Treatment in only 5 Sessions

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Posted 11/27/2013 1:12 AM (GMT 0)
Except from a Memorial Sloan-Kettering newsletter:

With the help of sophisticated image guidance and global positioning system (GPS) techniques, radiation oncologists are now able to offer prostate cancer patients a more focused approach to delivering higher doses of radiation more accurately and in less time than with IMRT.

Using a form of radiosurgery called stereotactic hypofractionated accelerated radiation to the prostate (SHARP), physicians can deliver ultrahigh doses of radiation in only five treatment sessions, compared with close to 50 sessions over ten weeks using the conventional approach.

“This kind of missile technology helps us and our medical physics colleagues localize the target with an accuracy akin to the sharpness of a surgeon’s scalpel, sculpt a high dose of radiation around the prostate, and effectively minimize the amount of normal tissue that’s included in that margin,” says radiation oncologist Michael J. Zelefsky. “In this way, we can safely give the entire course of radiation in only five treatment sessions with fewer side effects.”

-- Tigerfan
Posted 11/26/2013 8:36 PM (GMT -5)
TF, this is the type of radiation I am to receive in LA in the next couple of weeks, to two cancerous lymph nodes that have shown up on my recent scans. I don't know the total radiation I am to receive, but I do know that it will take place over 5 days.

Thanks for the info, I am sure it will help others at some point as an alternative method of first line treatment.

Sonny
Posted 11/26/2013 9:38 PM (GMT -5)
Great advancement.
Posted 11/27/2013 12:12 AM (GMT -5)
LOL! I like the new acronym SHARP. It's usually called SBRT, sometimes SABR, and popularly CyberKnife. I'm glad MSK finally woke up.
Posted 11/27/2013 6:29 AM (GMT -5)
Hypofractionated radiation delivery has been around for some time in the form of High Dose Rate brachytherapy. I had more radiation in two 15 minute HDR sessions than in 25 IMRT sessions. This SHARP advancement appears to be to IMRT/IGRT what HDR Brachytherapy is to permanent low dose seed brachytherapy.
Posted 11/27/2013 7:38 AM (GMT -5)
Tall Allen, I kind of laughed at the new acronym as well. If anyone is interested, I have my SBRT journey documented in the link below. So far, so good. No SE's at all and PSA on a downward trend.

Mike
Posted 11/27/2013 7:39 AM (GMT -5)
5 days beats the heck out of 9 weeks. I really hope this technology proves itself and matures into wide acceptance. Dragging back and forth to the radiation center for (in my case) 44 sessions was beyond tedious!
Posted 11/27/2013 8:37 AM (GMT -5)
5 days ? I hope this option is available to all someday.
Posted 11/27/2013 2:19 PM (GMT -5)
Agent,

It's been around since 2003 when Dr. King first used it for PC at Stanford. The link in my signature shows the latest 6-year results from Dr. Katz. ASTRO endorsed it last year. MSK is late getting in on it, but better late than never.
Posted 11/27/2013 4:12 PM (GMT -5)
I have had 2 sessions of SBRT one year apart hitting my prostate and 3 bone mets, with minimal and short lived bowel symptoms.  I found the procedure safe and effective.  See my piece in the Summer 2013 issue of PAACT magazine (www.paactusa.org).

Houseboy

 

Posted 12/13/2013 12:01 AM (GMT -5)
Well, I had to ask MSK ... How is SHARP different from Cyberknife?

This is the response I got, "We sent your inquiry to Dr. Zelefsky and he responded: "Cyberknife is a name of a company and the machine used to deliver radiation. SHARP delivers this kind of radiation from a high energy linear accelerator. The advantage of our SHARP program is that we routinely track the motion of the prostate during the actual treatment and can adjust the position of the beams even during the treatment as at times the prostate can have small shifts of its position. The Cyberknife system doesn't routinely do that."

--Tigerfan
Posted 12/13/2013 12:25 AM (GMT -5)
That's incorrect. CyberKnife does indeed track intrafractional motion and does it routinely. That was the whole reason it was used for this. There are now several systems that do that (I was treated with a RapidArc (VMAT) system that does that too. I don't know which system MSK is using.

The CyberKnife patient brochure said...
Real-Time Image Guidance – The CyberKnife System uses imaging software to track and continually adjust treatment for any movement of the patient or tumor.


CyberKnife Patient Brochure

It uses stereoscopic X-rays that track the fiducials relative to the plan image. If they misalign, the system stops mid-treatment and realigns.
Posted 12/13/2013 11:58 AM (GMT -5)
Fractionated radiation therapy have been used for tumors since at least the 1960s with the Gamma Knife. Been there done that for an AN in 1996. I believe the advances we're seeing have mostly to do with better imaging and developing machines to take advantage of that imaging. The GK, as I experienced it, seems rather crude compared to the newer stuff I read about today.

They all do the job they were designed for. The only danger I see is when some doc decides to wander outside the design parameters of a particular machine. Much has I appreciate what the GK did for me 17 years ago, I don't believe that technology is appropriate for PCa, though I have heard it being touted for just that purpose. If GK is your hammer....
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