According to Dattoli Cancer Center, with the most recent improvements in radiation therapy for prostate cancer, doctors can now give more accurate doses of radiation to the prostate. Dynamic Adaptive Radiotherapy for Prostate Cancer makes external beam radiation work better while reducing the number of side effects. Before treatment, fiducial markers can be put into the prostate to find out exactly where the cancerous tissue is. The new technology can find these markers. The radiation team can then change the amount of radiation and where it goes to kill the cancer cells without hurting the patient.
The technique uses multiple low-energy seed implants, so it can be used on people who don't have much tissue penetration. Patients who can get this type of radiotherapy have low-risk prostate cancer that has spread locally. A transrectal ultrasound is used to find out where the prostate tumor is, how big it is, and how much medicine is needed to treat it. CAT scans and MRIs are also used in certain modern procedures. Most of the time, the procedure takes about 90 minutes, and the person can go home the same day.
With a highly integrated approach to radiotherapy, it is also possible to target the tumor with great accuracy during treatment. Analyses using MRI and CT have shown that DART needs an advanced video tracking technology called Respiratory Gating. This lets the breathing motion be watched and changed in real time. Most centers don't use Respiratory Gating, but this technology can be used to target certain parts of the prostate and important tissues around it.
Dattoli Cancer Center described that, with this new method, dose escalation in prostate radiotherapy is done by changing the treatment plans every day. The plan is changed so that the patient's movements during interactions are taken into account. But there are two problems with how the therapy is done: the need for manual anatomical segmentation and the length of time the patient has to stay on the treatment table. Luckily, an automated online method has been made to divide up the anatomy of the prostate and plan the delivery of radiation therapy in an arc.
The Cancer Institute has been looking into how well this new way of treating prostate cancer works. The people who wrote the SPARK trial looked into whether or not this new technology could work. It is a way to use radiation that is guided by an image. In the future, it may be used more often to treat cancer. With this technology, the number of sessions needed for traditional radiotherapy could be cut down. The study also shows that this new technology can make the therapeutic ratio 10 percent better.
This method is also very helpful for people whose prostate cancer has come back in the same area. The radiation dose escalation is more precise and accurate, and patients can see the bulk of the tumor directly. With its precise way of increasing the dose, MRgRT could help stop cancer from coming back after a prostatectomy. Even though more clinical trials are needed to figure out how well MRgRT works, the results of this study will help doctors decide how to treat men with prostate cancer.
In Dattoli Cancer Center’s opinion, in this study, a treatment plan for prostate cancer patients was compared to an individual treatment plan based on the patient's DRR. In this phase-one study, the dose coverage of the tumor and the dose coverage of the front of the rectal wall were measured. It was important to think about how the treatment plan might affect a patient's organs and how it might change his or her life. The treatment plan was changed to work around these problems.
This study's results showed that MRgART is safe and effective, and that it can reduce toxicity in the GI tract and bladder. Also, when compared to standard RT, it showed statistically significant dose reductions. A clinical trial shows that this study is important. The study's authors say that it was paid for by the University of Southern Denmark, Odense University Hospital, and AgeCare, which are all international groups that work together to find ways to treat cancer.
The results were good. It was found that about 10% of people who got standard treatment didn't reach their goal. In a group of 263 men, the adaptive process missed a total of 12 seminal vesicles and 1.9% of the prostate. Wloch et al. also looked at the quality control of 1017 patients. The results showed that the MLC configuration was changed a second time for 96 patients, and 63 corrections were made to fix systematic errors that were still present.
The authors didn't include people with prostate cancer who had already had radiation to their lymph nodes. Patients who were getting androgen deprivation therapy were also left out of the study. Patients who had already had radiation therapy were also left out, as were those whose disease was in an intermediate-risk stage (PSA > 20) or had high-risk features (TNM stage of cT1-pT2 or N1-M1)