Tomo, as you know, can address a region with much more accurate dose regions to be able to accommodate the clinical behavior of the tumor in the environment.There are many ways to treat prostate cancer depending on your stage and condition. However, the best approach with the least side effects and the highest cure rate is with tomotherapy imrt image guided treatment. Nothing else matches the safety, the response, or the ease in receiving treatment.
Seeds are possible if you have a medium size prostate that is less than stage c, and has a gleasonï¿½s score less than 6 and a psa of less than 8. However, it has risks and complications that make it less attractive than imrt therapy. We used to treat with seeds allot, but this program was abandoned because the other therapies were more successful with less risk. Today, it has become popular again because both the urologist and the radiation oncologist can make more money with less time doing seeds rather than newer treatment. Tomo is relatively new form of imrt, but it is the culmination of years of work to achieve what we can now achieve.
Surgery is also possible, but there is no benefit of surgery over radiation and surgery is much more dangerous and has impotence and incontinence problems.
This is also a very feasable solution for salvage treatment plans. In florida south east regional's Dr. Rost has offred these types of treatment options.
Im surprised with a price tag of only 3 million more clinics do not have the tomotherapy machine. I believe fully loaded linac's with cone beam ct capabilities go for around the same price. I think the linac's with igrt capabilites are going to be the next wave in radiation treatments. Varian is refining their trilogy platform and the elekta synergyy is an impressive unit. I have seen both performing full igrt capabilities and this precise targeting is what we need for head and neck and lung treatments.
As for precision with prostate treatments the b.A.T. Ultrasound localization device by nomos is a very impressive tool. I use this on a daily basis and would hate to have to treat a patient without it. The precision it offers on a daily basis is quite impressive and I am confident that we are hitting the ctv with little or no healthy tissue in the volume.