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An update of advances in external beam radiotherapy for treatment of localized prostate cancerIn the past year or so there have been three significant technological advances in the use of external beam radiotherapy for the treatment of localized prostate cancer. It is about CyberKnife Radiotherapy, RapidArc Radiotherapy and Calypso system. Recently a research group provided a report to be sure that the patient community is both aware of and understands the limitations of these technological advances. The report concluded this that it seems likely that the combination of CyberKnife or RapidArc technology with the Calypso system is potentially likely to offer patients the highest quality of outcome to external beam radiotherapy with the minimal impact on their day to day lives. Whether this form of radiotherapy for localized prostate cancer will be as safe and effective as any other form of treatment may take longer to find. The Potential of CyberKnife Radiotherapy For the moment, we can say that single most important benefit of CyberKnife therapy is the fact that treatment can be carried out in just five clinic visits. This is a big progress compared to the 40 or so visits over 8 weeks required for conventional -modulated external beam radiation therapy (IMRT). To fully support the argument that CyberKnife therapy for localized prostate cancer is as effective and as safe as conventional IMRT, scientists need at least 5 years of follow up and collecting data.. The other issue that patients need to be aware of is that insurance coverage of CyberKnife radiation therapy for prostate cancer is variable. Even Medicare does not have national coverage for this technique, so you need to be sure that your insurer will cover this form of treatment. What About RapidArc Radiotherapy? The RapidArc technology IMRT that has been developed by Varian Oncology to offer a similar five-visit form of external beam radiation treatment to that offered using the CyberKnife. It is very clear that the idea of radiation treatment that can be delivered effectively and safely within short timeframes will be attractive to any patient. As with the CyberKnife technology, the accumulated data on treatment of patients with RapidArc technology is limited. Scientists would have liked to see some sort of registry trial put in place by Varian Oncology to track outcomes of all prostate cancer patients being treated with the RapidArc system. This way is possible to accumulate truly helpful outcomes data over time. Because of missing data, scientists really cannot say yet whether this form of technology is as effective and safe as traditional IMRT. Calypso Four-Dimensional Organ Location The application of Calypso Medical’s technology requires surgical placement of tiny “transponders” within the pelvis that can be used to track the actual position of the prostate at any point in time. These tranponsders can then communicate the precise position of the prostate to the computers controlling the radiotherapy beams to ensure that radiation is delivered with the greatest possible accuracy to the actual prostate, minimizing the potential for inadvertent and unwanted radiation of surrounding tissues. The main important benefit of this technology is that radiation therapy is delivered with absolute precision. On the other hand, the entire process therefore involves both urologists in the placement (and subsequent removal) of the transponders and the radiotherapy specialists in use of the equipment to manage radiotherapy. Despite of an extensive and growing literature on the use of the Calypso system that appears to be generally positive, however, again, scientists will really only be able to evaluate the clinical effectiveness and therapeutic value of this system in improving outcomes and reducing adverse effects when data is available over a period of at least 5 years. NOTE: Issues on this site regarding prostate cancer and treatment options, are provided for information only, and are not meant to substitute for the advice of your own physician or other medical professional. Prostate-Report.org does not endorse any specific product, service or treatment. |
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