elekta more MR guidance and hypofractionated RT for prostate cancer a good match

[Scout4answers]

Not yet being used for High risk patents with Lymph Node involvement...

focus.elekta.com/2020/11/mr...

[Justfor_]

It is a market driven decision. They want to set foot on the precision targeted irradiation which is currently occupied by the cyberknife and its siblings. If/when they will prove equal, they will get the bigger chunk as no fiducials are required. They are currently in a race and will not "waste" sessions for other wide field treatments like sRT. One the many European institutions that I contacted responded: "We treat prostate cancer, we do not offer salvage radiotherapy". As I like to say, when you don't know where the enemy is hiding use a hand grenade, don't call in a sniper. Yet, from the patient's angle it is good to know that organs to be spared will in fact be so and this by design and not by the experience + professionalism of the technician on duty.

[j-o-h-n in reply to Justfor_]

When you don't know where the enemy is hiding...... send out the 2nd Louie to find them......

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 01/20/2022 8:34 PM EST

[Justfor_ in reply to j-o-h-n]

2nd Louie like 2nd Lieutenant ?

[j-o-h-n in reply to Justfor_]

You drove that nail home........

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 01/20/2022 8:44 PM EST

[CAMPSOUPS in reply to j-o-h-n]

My nail has vanished.

[j-o-h-n in reply to CAMPSOUPS]

You used a cupped head nail ..... unlike what you used when you nailed a piece.....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 01/20/2022 9:00 PM EST

[Scout4answers in reply to Justfor_]

I have not had surgery or radiation yet but I do have involvement in 2 Lymph nodes, do you think any of the folks you contacted would take me on?

[Justfor_ in reply to Scout4answers]

I see slim possibilities for a 100% MR linac RT since there are few such machines in the USA. Alternatively, a combo treatment will be hard for them to turn down.

In particular:

1) Using the MR linac:

A small number of fractions exclusively targeting the prostate.

A boost dose to lymph nodes detected on a PSMA pet scan.

2) Using an ordinary IMRT or other machine:

A longer number of fractions covering the entire field.

Whether this combo defeats or not the patient's interest for safeguarding organs to be spared, I can't tell. It is a compromise solution and as such it performs.

FYI, in Heidelberg they use such a combo to save on proton.

[Concerned-wife in reply to Scout4answers]

I would contact Dr. H Nagar at Weill Cornell. Uses the Viewray MRI guided. He seemed to think outside the norm for my husband who has a bone met. I don’t know the answer about lymph. But he’d be responsive to your question, I believe. We video conferenced with him, then traveled to NY City for treatment.

[Scout4answers in reply to Concerned-wife]

Thank you for the suggestion

[Justfor_ in reply to Scout4answers]

With Viewray make certain that it is their latest machine, 2 years old at the most.

The first machine they placed in the market, more than 6 years ago, was using Cobalt as the source for radiation, to avoid interfering with the magnetic fields of MR. It is an obsolete system by any of today's standards.

[Scout4answers in reply to Justfor_]

thanks