COMPPARE that tests proton radiation against photon IMRT radiation.

Thanks for this.

Did this look at urinary side effects also? I don’t see it in the abstract.

Hi,
Just make sure your hospital network is using the latest hardware/software in either case. Even if the recent advances in Photon based radiation make it equal to Proton, I personally still like the concept of fixed beam length by design, it just makes sense. The study referenced did not say yes or no if space-or gel was used with Photon, it was at the discretion of the surgeon. Photon can damage the rectum if no gel is used as the beam passes past the cancer and exits the body. The gel is a very good idea if going with photon based in my humble non medical opinion. Choose wisely……..

Dave 3+4

@copyman
In my humble non medical opinion you are exactly correct. When you look at the technology Proton vs Photon are two different animals. I guess if, and I say if they use the space-or gel it stops the potential for damage to your colon. The gel is an added insurance in my opinion.
Dave 3+4

@jaygk
Urgency is discussed in both places. That’s a urinary issue. Unfortunately, they don’t discuss burning, which is another problem. The thing is, if there are bowel issues There are almost definitely urinary issues.

@clevelandguy The gels provide space but do not absorb either photons or protons. It moves the prostate away from the rectum so reduces damage from off-target radiation. Important with proton since it reduces the chance that a Bragg peak hits the rectum.

@jim18
From what I have read it does both. Creates a space between the Prostate and rectum and also absorbs photons. Thus the gel protects the rectum by doing two things.

It's always a good idea to read trial inclusion criteria and include it in discussions for context. For example, the trials mentioned in this thread excluded many men with High Risk PCa and all men with Very High Risk disease.

From the PartiQol Trial:
The study inclusion criteria were:

Males ≥ 18 years old
Histologically confirmed adenocarcinoma of the prostate
Clinical stage T1c-T2c
Gleason score ≤ 7
PSA <20 ng/mL
ECOG-PS 0 or 1

From the COMPARE Trial:
Treatment na¨ıve
patients with localized prostate cancer except those with very high-risk disease were eligible.

Bill

@brianjarvis Being informed as to what machines are out there - and currently being used by your treatment center - should really be a must…I agree.
I was lucky in that Sloan had a Varian TruBeam and used the newest software to ‘shape’ the beam…so far, so good.
Phil

@jim18 This is a very important consideration, spacers are more important with Proton in my view.