Sunday, September 25, 2022

Cyberknife Vs Imrt For Prostate Cancer

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Why Use Cyberknife For Prostate Cancer

IMRT vs SBRT vs Protons vs Brachytherapy | Ask a Prostate Expert, Mark Scholz, MD

Cyberknife is a good option for prostate cancer because:

  • Treatment is convenient and complete in fewer fractions 5 compared to 44 fractions in traditional radiation.
  • It spares more normal tissue.
  • It is more accurate than traditional radiation.
  • There are fewer side effects.
  • Treatment is performed as an outpatient procedure.

In addition, prostate cancer is a slower-growing tumor. Because prostate cancer cells are growing slowly, they may be more sensitive to higher doses of radiation per fraction than other cancers. This means that delivering radiation in larger doses in fewer treatment sessions may improve outcomes.

What Happens During The Procedure

Youll be placed in the proper position on a table. Then, a computer-controlled robot will move slowly around the table, targeting radiation where its needed. The software will adjust radiation for your breathing pattern and any movement of the tumor.

This is a noninvasive, painless procedure. Each session will last anywhere from 30 to 90 minutes. Once its over, you should be able to get up and resume your normal activities right away.

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Proton Beam Radiation Therapy

Proton beam therapy focuses beams of protons instead of x-rays on the cancer. Unlike x-rays, which release energy both before and after they hit their target, protons cause little damage to tissues they pass through and release their energy only after traveling a certain distance. This means that proton beam radiation can, in theory, deliver more radiation to the prostate while doing less damage to nearby normal tissues. Proton beam radiation can be aimed with techniques similar to 3D-CRT and IMRT.

Although in theory proton beam therapy might be more effective than using x-rays, so far studies have not shown if this is true. Right now, proton beam therapy is not widely available. The machines needed to make protons are very expensive, and they arent available in many centers in the United States. Proton beam radiation might not be covered by all insurance companies at this time.

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Types Of Radiation Therapy To Treat Prostate Cancer

Our doctors will work with the rest of your care team to help you choose treatments best for you. Radiation therapy is used for most cancer stages, from early-stage tumors to more advanced prostate cancer. There are 2 kinds of radiation therapy, internal and external:

  • Internal radiation therapy is when we implant something inside your body, such as radioactive seeds.
  • External radiation therapy takes place outside your body. This kind of therapy uses high-energy rays to damage cancer cells so its hard for them to grow.

An example of internal radiation therapy is brachytherapy . These procedures are outpatient treatments done under anesthesia, so youll be asleep. You can go home the same day. MSK doctors were among the first to offer this form of treatment.

External beam radiation therapy uses a treatment machine called a linear accelerator. It aims a beam of radiation directly to the prostate. The beam passes through your body and destroys cancer cells in its path. You wont see or feel the radiation. MSK uses EBRT to treat localized tumors. These are tumors that are only inside the prostate. If the prostate cancer has spread, we combine EBRT with brachytherapy or other therapies.

MSK uses 3 kinds of EBRT to treat prostate cancer:

  • Hypofractionated radiation therapy .
  • Proton therapy, which uses charged particles called protons to kill cancer cells.

Cyberknife Vs Gamma Knife

How is CyberKnife Different from Conventional Radiation

While there are many comparisons to the Gamma Knife, the CyberKnife System is the only dedicated stereotactic radiosurgery treatment technology that also can be used to deliver stereotactic body radiation therapy for treatments throughout the body.

Both the CyberKnife System and Gamma Knife are used to deliver stereotactic radiosurgery treatments to address tumors, vascular lesions, and functional disorders, such as trigeminal neuralgia or AVM. The treatments are designed to treat inoperable or recurrent brain tumors, and can be used for patients who do not want to endure the risks of surgery. However, there are some crucial differences between Gamma Knife and CyberKnife.

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Cyberknife Is More Accurate Than Traditional Radiation Therapy

Because its able to target diseased tissue, Cyberknife SBRT is much more accurate than traditional radiation therapy. SBRT can deliver radiation to a margin of one to five millimeters surrounding a tumor. Conventional radiotherapy has a radiation delivery margin of 20 to 30 millimeters. This much wider margin means that conventional radiotherapy is more likely to cause healthy tissue damage and side effects like radiation pneumonia. With SBRT, the most common side effect is mild fatigue following treatment.

How Does Sbrt Cyberknife Compare To Traditional Radiotherapy

Cyberknife is a form of targeted radiation therapy known as SBRT. SBRT, or stereotactic body radiation therapy, was adapted from central nervous system stereotactic radiosurgery, a treatment technique that has been used to treat tumors of the brain and central nervous system for over 30 years. The only real difference is that SBRT is used to treat tumors throughout the rest of the body instead of specifically in the brain.

How does SBRT compare to traditional radiation therapy? SBRT delivers radiation directly to the cancerous tissue, sparing the healthy tissue around it. As a result, it can be administered in fewer sessions, with fewer side effects, and with higher success rates.

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Radiation Therapy For Prostate Cancer

Radiation therapy uses high-energy rays or particles to kill cancer cells. Depending on the stage of the prostate cancer and other factors, radiation therapy might be used:

  • As the first treatment for cancer that is still just in the prostate gland and is low grade. Cure rates for men with these types of cancers are about the same as those for men treated with radical prostatectomy.
  • As part of the first treatment for cancers that have grown outside the prostate gland and into nearby tissues.
  • If the cancer is not removed completely or comes back in the area of the prostate after surgery.
  • If the cancer is advanced, to help keep the cancer under control for as long as possible and to help prevent or relieve symptoms.

Prostate Cancer: Surgery Vs Radiation Vs Cyberknife

CyberKnife vs. IMRT, IGRT, Rapid-Arc for Treating Lung Cancer

An analysis of more than a dozen studies indicate that prostate cancer patients do better with surgery vs. radiation treatment especially men with localized prostate cancer.

Patients treated with radiation are twice as likely to die from prostate cancer,one a half times likely to die sooner than prostate cancer patients treated with surgery, exposure to radiation may end in secondary cancers such as bladder cancer and rectal cancer.

Dr. David Samadi explores the details.

When men are diagnosed with prostate cancer it can be extremely confusing at times picking the right treatment option as theres a lot of information out there.

Dr David Samadi says that with any cancer, surgery should be the first line of treatment.

With prostate cancer surgery patients get accurate staging i.e. how much cancer a patient has, has the cancer spread to surrounding tissues the PSA levels which has always got to be zero.

He says that patients are led to believe that radiation is a viable first line of treatment if the cancer comes back, it is extremely difficult to perform surgery after radiation.

Dr. Samadi also explain why it is extremely important to weigh in the experience of the surgeon as working with the right doctor would ensure a better and faster recovery.

Dr. David Samadis patients have a continence percentage of 95% 97% regular sexual functionality in about 80% of prostate cancer patients.

Some prostate cancer facts:

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What You Need To Know About The Prostate Cyberknife Vs Imrt For Prostate Cancer

The main purpose of the prostate is to produce semen, a milky fluid that sperm swims in. During puberty, the body produces semen in a large number of cases, including enlarged prostate. This fluid causes the prostate to swell and cause a number of bladder-related symptoms. This is why the prostate is important to the body. It can be caused by many factors, including infection and inflammation.

A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.

While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.

Background On Radiation Therapy Treatments

Historically, much of the research into using radiation for prostate cancer has been focused on using much longer courses of radiation therapy. IMRT is a conventionally fractionated treatment, which typically involves 20-48 sessions over a period of four to ten weeks. The rationale for this go slow approach was to limit toxicity while still achieving a high cumulative dose of radiation, one sufficient to eradicate the cancer. By delivering small daily doses, the healthy tissue surrounding the targeted prostate that might be irradiated in the process is afforded time to repair itself between treatments.

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Sbrt Limits The Field Of Radiation

CyberKnife is a form of stereotactic body radiation therapy , which is a coordinated system to exactly locate the tumor and limit the field of radiation treatment. SBRT delivers a single high dose of radiation or a few fractionized radiation treatments.

There are various types of SBRT, and I believe CyberKnife is the best. CyberKnife utilizes a robotic arm to deliver radiation in different ways and at different angles.

Ever try to slice a grape? It almost seems to squiggle away from the blade, and can result in a poor cut or even a smashed grape. But if you hold that grape against the cutting board between two fingers so it doesnt move, you can slice it precisely the way you want.

The tumor under prostate cancer treatment acts much like the grape: It squiggles away. Thats because the prostate moves unpredictably, caused by air passing through the rectum and by the filling and emptying movements of the bladder, not to mention the patient sneezing or just breathing.

The CyberKnife Robotic Surgery System blends robotics, computer-processing power, advanced imaging and the surgeons skill to make instantaneous corrections in radiation delivery. This is possible despite any movement of the patient or the prostate cancer tumor being targeted.

Stereotactic Body Radiation Therapy Produces Impressive Results In Organ

Proton Therapy vs IMRT

Stereotactic body radiation therapy delivered via the CyberKnife can achieve excellent outcomes with minimal toxicity in patients with prostate cancer. Importantly, this technique delivers therapeutic doses of radiation in four to five fractions, which reduces the number of clinic visits from 8 weeks with standard intensity-modulated radiation therapy to 1 to 2.5 weeks for SBRT. This has huge implications for patient convenience and cost-savings to the health-care system, but experts agree that longer follow-up is needed. These findings of two prospective studies were reported at the 54th American Society for Radiation Oncology Annual Meeting in Boston.

Stereotactic body radiation therapy refers to ultraprecise delivery of very-high-dose radiation using converging, finely collimated beams . The CyberKnife system, based on robotic technology, was used to deliver SBRT in both studies. Typically, a course of radiation with CyberKnife SBRT takes five sessions. SBRT technology is currently available at about 150 centers in the United States.

Pooled Analysis

For this analysis, Dr. Katz contributed data from 515 consecutive patients, and the other 585 patients were treated at one of seven other centers. Among all patients, 59% were low-risk, 30% were intermediate-risk, and 11% were high-risk.

Related Presentation

Biochemical control was excellent , with only 1 of 129 patients who had a 2 ng/mL rise in PSA after the current nadir.

References

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Implications Of Implementing Mrgrt

There are challenges associated with fundamentally changing the workflow and the treatment we deliver. With constant MR imaging and the ability to change the plan daily, there is a risk of over-intervention. For example, if the small bowel sits close to the target on the daily image we may reduce coverage to the PTV in order to keep within our usual reference plan constraints. However, by the time the treatment is delivered the bladder will have filled and the bowel may have lifted, resulting in unnecessary under-dose to the target. We must remember that we have been safely delivering a single plan across a whole treatment course since the inception of fractionated radiotherapy and toxicity rates from prostate external beam radiotherapy are already low.

Replanning daily has significant implications for the workforce. Our current workflow requires two physicists, two radiographers and a clinician to be present for each fraction. Current research is focussed on streamlining this process and stratifying patients into those who do versus those who do not require daily adaptive replanning. We are also investigating the dosimetric impact of radiographer-led contouring. Our early work in an offline environment indicates a high concordance between radiographer and clinician contours .

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Symptomatic treatment of an enlarged prostate usually involves a combination of medication and lifestyle changes. A diet rich in fruits and vegetables may be the best option if you suffer from chronic urination. It will help the body adjust to the increased size of the prostate. Also, taking regular urination intervals will help retrain the bladder to function properly. Inactivity also contributes to urine retention, and cold temperatures can increase the urge to urinate.

Invasive treatment of enlarged prostate includes medication that relieves the pressure on the urethra and bladder. However, if the condition is severe, it may require surgical intervention. If treatment is not successful, the enlarged prostate can become a potentially life-threatening disease. As the hormone levels in the body change, the enlarged prostate can lead to various complications, including urinary retention and even cancer. This is why it is critical to see a doctor for further evaluation.

A physician can recommend a number of treatments to address an enlarged prostate. An enlarged prostate will require surgery to relieve the symptoms. In most cases, surgical treatment for an enlargement of the penis is enough. Moreover, a doctor may recommend a course of treatment based on symptoms. A TURP procedure is not painful and requires less recovery time than open surgery. The recovery period will be shorter and less traumatic.

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Radiation Therapy As Effective As Surgery For Prostate Cancer

New Brunswick, N.J., June 01, 2022 The American Cancer Society estimates about one in eight men will be diagnosed with prostate cancer during his lifetime. Radiotherapy is an excellent treatment for many men with prostate cancer providing a minimally-invasive treatment with low side effect risks. Ronald D. Ennis, MD, Professor and Vice Chair of Network Integration and Quality, Department of Radiation Oncology at Rutgers Cancer Institute, shares more about the topic.

What are the different types of radiation therapy offered for prostate cancer?

Radiation is an effective treatment for prostate cancer. It can be delivered by creating a beam of x-rays using an exceptionally sophisticated machine and shining that beam at the prostate via targeting methods having millimeter accuracy. Two forms of this treatment technology are Intensity-modulated radiation therapy and Cyberknife . Cyber knife delivers the treatment in fewer treatments. Cyberknife is not appropriate for all patients but is an excellent and effective option for many. IMRT uses advanced technology to manipulate photon and proton beams of radiation to conform to the shape of a tumor. Proton therapy uses a proton beam rather than x-rays and has the potential to cause less side effects since lower doses are delivered to tissues away from the prostate.

For those with prostate cancer, who is the best candidate for radiation therapy?

What are the benefits of radiation therapy for prostate cancer?

Radiopharmaceuticals That Target Psma

Choosing a Treatment for Intermediate Risk Prostate Cancer | Prostate Cancer Staging Guide

Prostate-specific membrane antigen is a protein that is often found in large amounts on prostate cancer cells.

Lutetium Lu 177 vipivotide tetraxetan is a radiopharmaceutical that attaches to PSMA, bringing radiation directly to the prostate cancer cells.

This drug can be used to treat prostate cancer that has spread and that has already been treated with hormone therapy and chemotherapy. The cancer cells must also have the PSMA protein. Your doctor will order a PSMA PET scan before you get this drug to make sure the cancer cells have PSMA.

This drug is given as an injection or infusion into a vein , typically once every 6 weeks for up to 6 doses.

Possible side effects

Some of the more common side effects of this drug include:

  • Feeling tired
  • Constipation

This drug can lower blood cell counts:

  • A low red blood cell count can cause tiredness, weakness, pale skin, or shortness of breath.
  • A low blood platelet count can lead to bleeding or bruising more easily than normal, or bleeding that is hard to stop.
  • A low white blood cell count can lead to an increased risk of infections, which might show as a fever, chills, sore throat, or mouth sores.

This drug might damage the kidneys. Your doctor or nurse will likely advise you to drink plenty of fluids and to urinate often before and after getting this drug, to help protect the kidneys. Tell your doctor or nurse if you start to pass less urine than is normal for you.

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