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    Best Prostate Cancer Radiation?

    Prostate Cancer External Beam Radiation: IMRT Beats 3D, Proton Beam

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    "The use of IMRT has skyrocketed in the past 10 years and it's good to see that this study affirms the use of IMRT to reduce side effects and to reduce the risk of additional therapy," Louis Potters, MD, chair of radiation medicine at North Shore University Hospital, Manhasset, N.Y., tells WebMD.

    Potters, who was not involved in the Chen study, says that IMRT costs more than 3D radiation, and that the new findings "validate" the procedure.

    Proton Beam Therapy vs. IMRT for Prostate Cancer

    But what about proton beam therapy, which costs even more than IMRT -- but which did no better in the Chen study?

    "This is not to say that at the end of the day, proton beam radiation is not right for prostate cancer," Potters says. "It's just we need to do additional study of it. And given the rate of construction of proton machines on a national level, the data should be more forthcoming to show whether it's worth the expense for prostate cancer."

    Chen notes that doctors switched from 3D conformational therapy to IMRT even before there was hard data to show it might be better. As more and more medical centers build proton beam facilities, he suggests that doctors might again switch to the next new thing.

    "We are saying, 'Wait a minute, let's compare outcomes before we jump to a new therapy,'" Chen says. "I don't think this study prevents a prostate cancer patient from choosing proton beam therapy. But it does tell him to ask his doctor about showing him data on whether protons are better."

    Much of the data that is available contradicts the Chen study, says Nancy Mendenhall, MD, medical director of the University of Florida Proton Therapy Institute and associate chair of the university's department of radiation oncology.

    Mendenhall says the Chen study fails to collect important data, such as the doses radiation patients received, exactly how well their tumors responded to treatment, and exactly which toxicities the patients suffered.

    She says that studies from proton therapy centers find far lower rates of side effects than the Chen study did.

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