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SBRT: Every day or every other day; proton or photon?
Thanks to everyone for their participation in this forum. Your comments and questions have been enormously helpful to me. I'm considering SBRT and trying to determine the answer to two questions: (1) if you have the choice, should you push to do radiation every other day (or simply not continuous days in a row) just to give your body a rest; and (2) if you have the choice (all things being equal) between SBRT with photon or proton machines, which is better? Thank you for any and all reactions
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@bhdc
Has to come from within yourself of what is best for you not what was best for me or others.
Both high dose and low dose radiation have their pros and cons. Same goes for proton radiation and photon radiation. They have almost identical success rates. What is different in may cases is side affects or different types of treatments and dealing with long term treatments low dose and high dose short treatment times.
For me I chose 30 rounds of proton radiation. Why? I had two different opinions visits. Then met with my PCP at Mayo and we decided as a team what was best for me not only physically but mentally.
@dribbles
I meant the Varian Ethos not ProBeam
This is my first time commenting on this page. I hope I am doing this correctly.
Can I get some opinions on the following:
I had a HoLEP procedure on Feb. 26, 2026 and I am recovering fine. I will be ready for Radiation Treatment around the end of May 2026.
Per a consultation with my Dr. at Mayo on Sept. 4 2025, this was my treatment plan:
-Photon SBRT 5 fractions every other day. 700cGy per fraction
-IGRT x-ray images with fiducial markers used before each fraction/ no real-time MRI-guided Imaging
-VMAT delivery, BioProtect rectal spacer.
Is this still a good plan? I am concerned about VMAT vs. the newer delivery methods and what is available at Mayo.
VMAT seems to be used more frequently recently, using 3-D to better isolate the radiation to the prostate area.
MRI guided SBRT using like the ViewRay MRIdian and Elekta Unity Are much newer and may have smaller margins.
The incidents of secondary cancers are very low with those that have SBRT or IMRT. There is a slightly lower chance of affecting the bowels or bladder/urethra, But they all still seems to cause cystitis in some cases and bowel problems in very few cases.
I had 40 sessions of salvage radiation using IMRT 12 years ago. No problems with anything though six years later, I did start having incontinence issues. That could’ve been due to a prostatectomy 16 years ago as well.
@ecsalazar
My SBRT treatment did not have MRI guidance although it was available. My RO used an ETHOS device which created an image of the region each day prior to treatment. The treatment plan was adjusted with AI according to the observed position of the prostate and other organs on that day. I also had fiducials and a SpaceOAR inserted a month before treatment.