Smith_bp101@hotmail.com asked this question:
> Is proton therapy becoming more popular? Still doesn't seem to
> to be any long term studies, unless I'm mistaken.
Define "long term" in your own words.
Do you mean 2 years? 5 years? 10 years?
For how many years has proton therapy been popular?
We can't expect "long term studies" until it's been
used long term.
Visit here and look for "proton."
http://www.cancer.gov/cancertopics/factsheet/Therapy/radiation
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Dick Smith - 09 Apr 2008 16:00 GMT
Long term would be 10 years. I'm under the impression that treatment
via proton therapy has been available since the early/mid 90's.
> Smith_bp...@hotmail.com asked this question:
>
[quoted text clipped - 14 lines]
> http://www.cancer.gov/cancertopics/factsheet/Therapy/radiation
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CW89134 - 09 Apr 2008 19:54 GMT
> Long term would be 10 years. I'm under the impression that treatment
> via proton therapy has been available since the early/mid 90's.
Loma Linda has been using proton therapy since approximately 1991. We
were told that about 2/3 of their proton patients are prostate cancer
cases.
Carol
ron - 09 Apr 2008 20:28 GMT
See "Proton Therapy for Prostate Cancer: the Initial Loma Linda
University Experience" (Int J Radiat Oncol Biol Phys. 2004 Jun 1;59(2):
348-52; Slater JD, Rossi CJ Jr, Yonemoto LT, Bush DA, Jabola BR, Levy
RP, Grove RI, Preston W, Slater JM). In this paper, the median follow-
up is 62 months and results are statistically projected out to 10
years using standard techniques. Although the results are not
stratified in great detail, they still allow comparison to the
Hopkins' surgical 10-year projections (see M. Han, A. W. Partin, M.
Zahurak, S. Piantadosi, J. Epstein and P. C. Walsh; J. Urol., 169,
517-523, 2003; the paper can be found at
http://www.prostate-help.org/download/jhnomo.pdf). Compare the two
sets of results and draw your own conclusions. A few points to keep
in mind,
1) many of the men in the Loma Linda paper were treated with a mix of
photons and protons
2) the Loma Linda researchers used the ASTRO definition of failure
(DOF) whereas Hopkins used PSA>0.2 ng/ml. At median follow-ups around
5 years, different researchers have found that 10-year recurrence-free
projections comparing the "PSA>0.2 ng/ml" DOF and the ASTRO DOF on the
same underlying population leads to differences in failure rates
ranging from 15-35% with ASTRO being the more forgiving (see for
example, 1) American Society of Therapeutic Radiology and Oncology
consensus definition; J Urol. 2002 Mar;167(3):1310-3; Critz, FA., 2) J
Urol. 2001 Apr;165(4):1146-51; Amling CL, Bergstralh EJ, Blute ML,
Slezak JM, Zincke H).
...ron
Califchief - 10 Apr 2008 08:00 GMT
Ron told us to click on this link"
> See "Proton Therapy for Prostate Cancer: the Initial Loma Linda
> University Experience"
> the paper can be found at
> http://www.prostate-help.org/download/jhnomo.pdf).
I landed on the following when I clicked on that URL:
"BIOCHEMICAL (PROSTATE SPECIFIC ANTIGEN) RECURRENCE
PROBABILITY FOLLOWING RADICAL PROSTATECTOME FOR
CLINICALLY LOCALIZED PROSTATE CANCER"
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Alan Meyer - 11 Apr 2008 00:07 GMT
...
> > Is proton therapy becoming more popular? Still doesn't seem
> > to to be any long term studies, unless I'm mistaken.
...
Googling around, I found an article, dated June 29, 2006, by one
Dr. James Metz of the Abramson Cancer Center of the University
of Pennsylvania. He offers detailed statistics comparing side
effects and efficacy of proton therapy vs. "conventional
radiation therapy" (no definition given) vs. prostatectomy (no
definition there either.)
The author claims significantly better side effect profiles and
significantly better prostate cancer control for proton therapy
over either of the other treatments. He also compares side
effect profiles for proton vs. "conventional radiation" therapy
for several other types of cancer.
Unfortunately, the article appears to offer no information
whatsoever on how the statistics were derived. I couldn't find
any sources for any of the data. That's unacceptable in a
scientific publication and unconscionable even in popular
publications like this one. Some years ago that would have
surprised me coming from a doctor at a prestigious academic
institution, but I've learned not to be surprised by such things
coming from our profit and prestige driven medical establishment.
Given these limitations, I almost hesitate to cite the source,
but here it is:
"Reduced Normal Tissue Toxicity With Proton Therapy", by James
Metz, MD.
http://www.oncolink.org/treatment/article.cfm?c=9&s=70&id=211
I found the author's email address and wrote to him to request
citations for the sources. If he responds (and maybe if he
doesn't), I'll post what I find out.
Alan
Eddie - 11 Apr 2008 00:36 GMT
>...
>> > Is proton therapy becoming more popular? Still doesn't seem
[quoted text clipped - 36 lines]
>
> Alan
Could it have something to do with the fact that the Univ of PA is the
process of installing their own Proton therapy machine to open next
year at the cost of many millions?
Alan Meyer - 11 Apr 2008 00:45 GMT
> >... Some years ago that would have
> >surprised me coming from a doctor at a prestigious academic
[quoted text clipped - 4 lines]
> process of installing their own Proton therapy machine to open next
> year at the cost of many millions?
It could indeed.
Alan