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Any diet restrictions with radiation? What were your side effects?
Prostate Cancer | Last Active: Jun 8, 2023 | Replies (46)Comment receiving replies
Hi bens1
What was the month and year of your MRIdian treatments? According to the Viewray MRIdian website as of June 5, 2023 it seems that they no longer use a CT scan but rather use their newest MRI machne which is integrated with a proton beam machine (Linac). No fusion of images are used. Could it be that your machine was an older model? The site says "Findings published on January 12, 2023, in JAMA Oncology demonstrate the superiority of MRIdian "MRI guidance" in stereotactic body radiotherapy (SBRT) for localized prostate cancer compared to "CT-guided" SBRT. Then says MIRAGE phase III randomized controlled trial (NCT04384770) shows a significant reduction in acute (≤90 days) genitourinary (GU) and gastrointestinal (GI) side effects with MRIdian MRI-guided versus CT-guided SBRT." I believe Viewray mentioned that fiducial markers are no longer required, however is SpaceOar still being inserted? Is it possible I'm confusing your CT scan for "mapping purposes" with a radiation treatment which uses a CT scan along with a proton beam machine? More detail would be helpful.
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web265: I started my MRIdian treatment in January of this year and finished my 5 treatments in February, mid month. I had a ct scan and an MRI before my treatment to help with mapping. Those images were used within the machine for comparison purposes as the built in MRI was primary for real time mapping and process purposes. Different cancer centers seem to treat imag mapping and preparation in slightly different ways. I knew this going in and had no problems with "extra just in case mapping". When I had the spaceoar put in, my RO also inserted fiducials in case my machine broke down. I had no problem with that either but would have started the treatments again after the machine was repaired but I was ok with anything that gave her a better mapping perspective. Fiducials and more imaging was not necessarily needed but again, I had no problem with that kind of "extra."
I had seen the Mirage study both online and I discussed it with 3 of the 5 RO's I had consultations with so I was aware of the results. It was the Mirage study that was the impetus for my Orlando's cancer center to change their policy to 2 mm margins from 3 mm.
Spaceoar was first suggested by the first 2 RO's I spoke with but I brought it up to the other 3 and they agreed it made sense. The first RO who brought it up was at Weill Cornell in New York city and his time with the mridian machine has been primarily prostates. He used spaceoar regularly though he did defer to the patients wishes if they wanted a different type of spaceoar from another company but he was a spaceoar believer. He felt that the extra 1/2 inch separation between the rectum and the prostate made a difference even though the Mirage study did take spaceoar and no spaceoar into account.