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SpaceOAR causing issues

Prostate Cancer | Last Active: May 1 10:25am | Replies (59)

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@vircet

Thanks, Phil. I had 8 Gy per treatment x 5 = 40 Gy cumulative. If this is too private for you, can you reply by private message how many Gy cumulative you had over 2 treatments?
I appreciate your putting into perspective, the fact that radiation passes through the body. All along I thought it stops at the target -- the beams came from many directions and meet at the target point. so I thought the "focus beams" stop where they met, now I got to think they disperse again beyond the target and out to the other side of the body. May b e I will do some more reading about how Elekta Versa HD works. Before my treatments began, I discussed MR-Linac with my oncologist, but it was after my second treatment that MR-Linac wasn't the one used for me. The cancer center has many other Elektas but only one MR-Linac which alone cannot treat all patients. I was told that some patients could not have fiducial markers implanted, in those cases they get treated with with MR-Linac. (I got the impression that if the prostate moves out of target position, the machine stops and adjusts before resuming radiation. If so, I wonder if after hitting the target, do the beams scatter on the way out of the body? I would not be asking my oncologist anymore about this -- too late now, maybe I should have asked before my treatment began?)

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Replies to "Thanks, Phil. I had 8 Gy per treatment x 5 = 40 Gy cumulative. If this..."

Hey Vircet, the Linac doesn’t need fiducials because it tracks the prostate in 3D with realtime MRI. Cyberknife uses tomography to track the fiducials which are placed at 3 points on the gland - but it follows the fiducials regardless of gas bubbles or peristalsis moving delicate structures into the path of the beam.
The Linac shuts off if the gland/margin moves out of the target area but the CAT doesn’t - very clear advantage to avoiding tissue damage.
Also, MRI is not - as far as I know - compatible with metal so if you had fiducials placed I cannot imagine that they used an MRI based machine.
Only proton radiation has beams which STOP at the target - all photonic technologies use electrons that pass thru the target. When I first consulted with an RO who used MRIdian he said I would need a spacer.
As far as my radiation I would have to check but I saw a post treatment report which said 6000 to prostate bed and 4500 to pelvic nodes. Don’t think it was expressed in Gy, however.
Phil