Prostate Cancer Studies

Extreme hypofractionated proton radiotherapy for prostate cancer using pencil beam scanning: Dosimetry, acute toxicity and preliminary results

Quality of life and toxicity from passively scattered and spot-scanning proton beam therapy for localized prostate cancer

Comparison of conventional-dose vs high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate

Comparison of high-dose proton radiotherapy and brachytherapy in localized prostate cancer: a case-matched analysis

Dose-volume comparison of proton therapy and intensity-modulated radiotherapy for prostate cancer

Early outcomes from three prospective trials of image-guided proton therapy for prostate cancer

Erectile function, incontinence, and other quality of life outcomes following proton therapy for prostate cancer in men 60 years old and younger

Five-Year Outcomes from 3 Prospective Trials of Image-Guided Proton Therapy for Prostate Cancer

Hypo-fractionated passively scattered proton radiotherapy for low-and intermediate-risk prostate cancer is not associated with post-treatment testosterone suppression

Long-term quality of life outcome after proton beam monotherapy for localized prostate cancer

Management of complications of prostate cancer treatment

Patient-reported long-term outcomes after conventional and high-dose combined proton and photon radiation for early prostate cancer

Urinary functional outcomes and toxicity five years after proton therapy for low-and intermediate-risk prostate cancer: results of two prospective trials

Long-term Efficacy and Toxicity of Hypofractionated Salvage Radiation Therapy for Biochemically Recurrent Prostate Cancer

Prague Proton Therapy Center Study Shows Proton Therapy Greatly Reduces the Risk of Side Effects Compared with Conventional Radiotherapy

Patients who undergo conventional radiotherapy treatment are exposed to a far greater amount of unnecessary radiation to healthy tissue, in comparison to patients undergoing proton therapy treatment. As a more targeted treatment modality, proton therapy spares a greater quantity of healthy tissue. Treatment plans using proton radiotherapy reduce radiation exposure by 50% compared to conventional radiotherapy treatment.

The Prague Proton Therapy Center Medical Team published their treatment plan comparison findings for patients with advanced prostate carcinoma in the December 2019 edition of Radiation Protection Dosimetry, entitled ‘Low dose bath from IMPT vs IMXT for the pelvic area when treating advanced prostate cancer‘. This study compared treatment plans for patients undergoing Intensity Modulated Proton Therapy (IMPT) with patients undergoing conventional Intensity Modulated X-Ray Therapy (IMXT) for advanced prostate cancer.

Existing studies have already shown that cancer patients receiving proton therapy experience a significantly lower risk of unnecessary side-effects from radiation therapy in comparison to patients receiving traditional photon radiation. Cure rates remain however essentially identical between the two groups.

The results of this study confirm these existing findings, demonstrating the clear superiority of proton therapy over conventional x-ray (photon) radiotherapy. Proton therapy treatment was shown to halve the amount of dangerous radiation exposure to the abdominal cavity and rectum (50% less radiation to healthy tissue). This thereby reduces the risk of side-effects and offers patients a greater chance at maintaining a higher quality of life during and after their cancer treatment.

Proton therapy was also shown to use a significantly lower number of treatment fields for the same target dose coverage, when compared to conventional photon (x-ray) treatment techniques. The authors state that proton therapy treatment ‘irradiates just half of the tissue volume with a low dose compared to conventional x-ray treatments without compromise in target volume coverage’. In this way the risk of secondary cancer development and other possible complications is also greatly reduced.

Optimum proton dose distributions can be achieved with intensity modulated proton therapy. Currently, proton therapy is undergoing transitions that will move it into the mainstream of cancer treatment. For example, proton therapy is now reimbursed, there has been rapid development in proton therapy technology, and many new options are available for equipment, facility configuration, and financing.

Proton therapy might be an appropriate treatment option for you or a loved one that is suffering from cancer. Please contact us if you would like to find out more.

Associated Resources:

B. Glimelius, U. Isacsson, E. Blomquist, E. Grusell, B. Jung, and A. Montelius, “ Potential gains using high‐energy protons for therapy of malignant tumors,” Acta Oncol. 10.1080/028418699431537 38, 137– 145 (1999)

B. Glimelius et al., “ Number of patients potentially eligible for proton therapy,” Acta Oncol. 10.1080/02841860500361049 44, 836– 849 (2005)

R. Flynn, D. Barbee, T. Mackie, and R. Jeraj, “ Comparison of intensity modulated x‐ray therapy and intensity modulated proton therapy for selective subvolume boosting: A phantom study,” Phys. Med. Biol. 10.1088/0031‐9155/52/20/001 52, 6073– 6091 (2007)

L. Haisen, H. Romeijn, H. Fox, J. Palta, and J. Dempsey, “ A computational implementation and comparison of several intensity modulated proton therapy treatment planning algorithms,” Med. Phys. 10.1118/1.2836954 35, 1103– 1112 (2008)

A. J. Lomax et al., “ A treatment planning inter‐comparison of protons and intensity‐modulated photon therapy,” Radiother. Oncol. 10.1016/S0167‐8140(99)00036‐5 51, 257– 271 (1999)

Luca’s Craniopharyngioma Story

Luca is a young boy who was diagnosed with craniopharyngioma. His mother, Mariana, has decided to share their journey.

When I found out about Luca’s craniopharyngioma I started researching all the possible treatment opinions both in my country, Romania, and abroad. At that time, there were three neurosurgeons in America with whom I corresponded and they recommended surgical removal of the tumor followed by proton therapy. It was the first time I heard of such therapy.

Two surgeries were performed in the hospitals in Bucharest and the tumor was completely removed along with the pituitary gland. The doctors hoped that everything would go well and we would not need proton therapy. Shortly after, however, we realised that it was not the case and the doctors gave us two options: we could repeat the surgeries whenever the tumor recurred or we could do proton therapy. We chose proton therapy. We had to decide which of the centres in Europe to go to. A Romanian student who was studying in Prague recommended us the Proton Therapy Center (PTC). He recommended PTC as it is one of the newest centres, therefore with the latest technology, but also with a lot of experience and well trained doctors. Thus Prague became our home for two months. We didn’t imagine that treating such a disease could go so smoothly!

Before going to Prague for Luca’s treatment, I had never left Romania. I didn’t know any foreign language but Susanna, the treatment coordinator who was assigned to our case, helped us with all the details. Susanna found the accommodation most suitable for us, she informed us in detail and patiently explained each step of the process, always making sure we understood. Moreover, the PTC organised for a car to pick us up at the airport as well as take us back to the airport at the end of Luca’s treatment.

Luca loves the Proton Therapy Center and the people here. He didn’t experience any side effects, hair loss, or nausea. In addition Luca began to love walking because of the many beautiful places Prague has to offer!

Easter Traditions in the Czech Republic

Easter, known as Velikonoce, in the Czech Republic is a celebration of the arrival of spring. Celebrated on Monday, not Sunday, Easter has many unusual traditions that may vary depending on the region. Some of the most popular Easter traditions and symbols include:

Kraslice (Easter eggs) – girls decorate Easter eggs using a variety of techniques. The eggs will be given to the boys on Easter Monday.

Pomlázka (Pussywillow) – it is thought that by whipping someone with pussywillow twigs you bring them health and youth. Boys will collect twigs and braid them to create whips, which will then be used to whip the girls while reciting a short Easter poem. The girls reward the boys with candy, a painted egg or a ribbon to tie around his whip.

Lamb shaped cake – a staple of any Czech Easter meal. Other dishes that are common for Easter include potato salad, gingerbread and in many households, slivovice which is homemade plum brandy.

The colour red – symbolising the energy of new life, which is what spring brings. Many people will dye their eggs red or wear a red outfit during Easter.

The warning off of Judas – during holy week, for three days, boys will travel around their village shaking wooden rattles to scare off Judas. On Saturday, the third day, the boys will make their rounds to houses where they will make noise with their rattles until they are given a present.

Proton Beam Therapy vs Intensity-Modulated Radiation Therapy for Locally Advanced Oesophageal Cancer

Radiation therapy has become an important component in the curative management of oesophageal cancer worldwide. Since most of the oesophageal cancers seen in the Western hemisphere (i.e., Europe and the United States) are located in the mid- to distal-oesophageal locations, heart and lungs invariably receive significant radiation doses. Much of the normal tissue exposure could be reduced with the utilisation of advanced radiation technologies such as intensity modulated proton therapy. Proton beam therapy (PBT) provides the ability to reduce normal tissue exposure (compared to conventional treatments) due to its lack of exit dose, which enables medical teams to provide clinically meaningful benefits to oesophageal cancer patients.

A Randomized Trial of Proton Beam Therapy Versus Intensity-Modulated Radiation Therapy for Locally Advanced oesophageal Cancer found that proton beam therapy was associated with less toxicity and similar progression-free survival vs intensity-modulated radiation therapy in patients with locally advanced oesophageal cancer.

In the trial, 145 patients were randomly assigned to proton beam therapy or intensity-modulated radiation therapy. Median follow-up was 44.1 months. The posterior mean total toxicity burden was 2.3 times higher in the intensity-modulated radiation therapy group vs the proton beam therapy group. The mean postoperative complication score was 7.6 times higher in the intensity-modulated radiation therapy group vs the proton beam therapy group (2.5, 95% highest posterior density interval = 0.3–5.2). At 3 years, overall survival was 51.2% vs 50.8% and median overall survival was 42.1 months vs 73.6 months.

The investigators concluded: “For locally advanced oesophageal cancer, proton beam therapy reduced the risk and severity of adverse events compared with intensity-modulated radiation therapy while maintaining similar progression-free survival.”

Treating oesophageal cancer with an adequate dose of radiation can be difficult because of the close proximity of the oesophagus to critical structures, such as the heart, lungs and spinal cord. Because protons deposit their highest dose of radiation at the tumor or area of concern, proton therapy can be an excellent choice for treating patients with oesophageal cancer.

Proton therapy offers patients and their doctors a unique option for effectively treating oesophageal cancer while reducing damage to other critical organs and tissues. The Prague Proton Therapy Center is one of the few centres of its kind treating oesophageal cancer with proton technology.