Mooching around the internet, as you do, I found this. It’s one of many articles from USA hospitals.
Quality of life is so important especially as so many younger people are being diagnosed, cured and living for many years with the sequels of radiation.
Then I found this
So disappointing. We can only hope that one day we can look forward to IMPT being as routine as IMRT
Today my coffee tastes like Christmas in Costa Rica 
Hi thanks dadthebikeracer
That’s a very useful post.
There is a trial just starting in the UK. It’s called TORPEdO so we may find out. I have read that patients receiving Intensity Modulated Protons get re scanned at three weeks so that adjustments to the treatment area can be done. It’s a fast moving field.
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Hi!
As I understand it the UK NHS IMRT is now as good as PBT in every respect except where a very heavy precise dose is required e.g. in or around the brain. Or for children where the toxicity is an issue. I think in both of these circumstances the NHS will send you to Christies or Royal Marsden.
For virtually everything else IMRT is just as good – it’s accurate (to 1mm) with limited spread characteristics – and it’s worth remembering the dosage is the same for both approaches – it’s just the targeting. In most cases some degree of spread is preferred anyway, to catch any stray cells. Also, PBT needs the same number of sessions but each one takes longer due to the long set up time; that accounts for much of the cost.
I was fortunate in having the choice of treatments – PBT or IMRT for adjuvant treatment following head and neck surgery. I opted for the IMRT.
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Hi, reference the PBT. In the UK the IMRT is so much better these days – almost as accurate as PBT, and simpler and quicker to administer. PBT is now really for only when a really heavy targeted does is required. The total dose is the same as a ‘standard’ RT dose, it’s just more concentrated. And it takes c 45 minutes a session to get the targeting right, so really onerous for the patient. It will be right for some specific conditions, but for most IMRT is the appropriate treatment. The NHS will use PBT, but mainly for children where toxicity is an issue, or for tumours in and around the brain.
[I was fortunate – I had the choice – and opted for ‘conventional’ IMRT].
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Well the new trial might make things clearer. I know hindsight is a wonderful thing but if I knew then what I know now about loss of saliva, trashed salivary glands and ruined taste I would happily have spent an hour on that treatment table if there was a promise of fewer side effects. A few centres in The States are using it.
We shall see.
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