Proton or IMRT for salvage treatment

Last I heard, the treatment efficacy is no different, but the side effects are a bit less since the proton therapy better targets the exact depth of the region to hit.
Jeff

As I understand the advantages of Proton beam, thinner beam and Bragg peak, do not make it better for salvage therapy as you need to radiate an area broader than the surgery field. When you are mopping up what was missed and you really don't know exactly where the cancer might be, the narrowly focused method is not the best.

As to lower PBT side effects for PCa, no side by side study has shown that particularly when measured against today's advanced photon beam radiotherapy including IMRT, IGRT, and SBRT. Because of these advances over the last 10 years and the much higher cost of Proton beam, it does not appear to be growing in its use in PCa. It hasn't proven to be better than the other methods for PCa and many insurance companies won't approve the much higher costs. One center closed last year at Indiana University, primarily due to lack of profitability. In Atlanta a new center will open next year. There are many cancers that it is very well suited for particularly head and neck, and pediatric cancers.

If it can be discerned....go with the most experienced team at doing prostate salvage radiation specifically. RO, physicist, techs, etc. And in a perfect world...that would also the same RO you trust most.

Trust is important.

Congratulations TX.

Post Edited (island time) : 12/23/2015 7:02:21 AM (GMT-7)

Why not get a free phone consultation from one of the best ROs for PCa: Dr. Dattoli in Sarasota FL?

He is a PCa specialist who, as he states "lives and breathes prostate cancer treatment." He uses a more accurate form of IMRT he calls Dynamic Adaptive Radiation Therapy that accounts for your breathing and other factors. Every aspect of his treatment is state of the art.

I had SRT that ended in July this year at the Dattoli Cancer Center and highly recommend them.

As I understand it the benefits of proton therapy stem from its ability to treat a small area, sparing nearby tissues. That makes protons great for brain tumors, OK for radiating prostates, and slightly pointless for prostate salvage where it is all the nearby tissues that must be targeted. Its a bit like digging a swimming pool with a teaspoon. It can be done, mind you, if your institution has a proton machine to keep busy and they only charge IMRT prices for salvage, then why not? They can program it to zap pretty much every bit between navel and anus one very-precise smidgen at a time, but the results are generally indistinguishable from IMRT which is usually cheaper.