Does the efficacy increase and longterm side effects decease for SRT with each passing year?

[jronne]

how much if any improvement in SRT occurs with each year, are advancements continually happening compared to SRT years ago

[Tall_Allen]

Yes, machines are getting more precise, but soft tissue motion is a limitation.

[jronne in reply to Tall_Allen]

as I understand it your body is not strapped into a fixed well-known location during SRT

I would be great if they could map the pelvic region in a rigorous repeatable manner

[Tall_Allen in reply to jronne]

No- they do a mold and fractionally adjust your position on the table with lasers to get it as precise as possible. But soft tissue is deformable, especially with no prostate in place. UCSF uses fiducials in the fossa, but I don't know how well they stay in place. Most site on long bones, but as I said, soft tissue is deformable. That's why side effects are worse for SRT than for primary IMRT. They reduce the dose to reduce toxicity. That's why I always say it's a bad idea to start with an RP knowing SRT will follow. If it turns out that way, that's another thing, and is unavoidable.

[jronne in reply to Tall_Allen]

so the room for future improvement is limited correct ?

[Tall_Allen in reply to jronne]

No - there are always innovations. I know there are experiments in tissue glues that show up on CT. Mack Roach is really the best person to ask, as I suggested.