A new, large study shows that intensity modulated radiation therapy (IMRT) is better than conventional conformal radiation therapy (CRT) at reducing side effects and prostate cancer recurrences (cancer that comes back after treatment) and it is less expensive than CRT and proton therapy. Both IMRT and CRT are types of radiation therapy that are designed to aim beams of radiation directly at a tumor. IMRT is better than CRT at varying the strength of the radiation so the tumor gets more radiation and the healthy tissue gets less. Proton therapy is a type of radiation therapy that uses protons instead of x-rays to treat cancer.
In the study, the researchers looked at data in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database from more than 12,000 men with prostate cancer that had not spread beyond the prostate who received CRT, IMRT, or proton beam radiation. The researchers found that IMRT reduced gastrointestinal side effects (problems caused by radiation to the area around the prostate, which also can affect the healthy tissue in the bowel) by 9% and hip fractures by 22% when compared with CRT. In addition, men who received IMRT were less likely to need additional cancer treatments than those who received CRT. The researchers also found that men who received proton therapy had more gastrointestinal side effects, but were equally likely to have other side effect or need additional treatments than those who received IMRT.
The study was led by Nathan Sheets, MD, a third-year radiation oncology resident at the University of North Carolina (UNC) at Chapel Hill and 2012 Conquer Cancer Foundation of ASCO Merit Award recipient.
What this means for patients
“There have not been many studies that directly compare new radiation therapy options to older ones,” said senior author Ronald Chen, MD, MPH, Assistant Professor of Radiation Oncology at UNC at Chapel Hill and Research Fellow at the Sheps Center for Health Services Research at UNC. “In the past 10 years, IMRT has largely replaced CRT as the main radiation technique for prostate cancer. This study supports this change, showing that IMRT better controls prostate cancer and results in fewer side effects.”
Questions to Ask Your Doctor
- What type of prostate cancer do I have? What is the stage?
- What are my treatment options?
- What treatment plan do you recommend? Why?
- What are the short-term and long-term side effects of the recommended treatment?
- Will radiation therapy be a part of this plan? If so, what type will be used?
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