Can Obese Prostate Cancer Patients Benefit More from Image-Guided Radiation Therapy

In the recent past a number of studies have demonstrated that the rates of clinical reoccurrence or biochemical failure in prostate cancer patients was significantly increased in individuals who were classified as obese. A joint team of researchers from the Carol G. Simon Cancer Center, Morristown Memorial Hospital in Morristown, N.J. and the Uematsu-Atsuchi-Serendipity Oncology Center in Terukuni, Kagoshima, Japan recently set out to try to determine if the failure rates were caused in part by the treatment modalities used in these patients or whether the fact that they were obese was the sole reason.

They found that in those patients who fell into the moderate to severely obese category- having a BMI of 35 or above- experience greater shifts of the prostate during the course of treatment. This may lead to radiation treatments not being delivered to the specific site necessary for their optimum outcome at all times. The patients involved in the study were all undergoing a treatment called EBRT.

There is a newer alternative to EBRT treatment, called IGRT. This utilizes the same technology as ERBT but also makes use of imaging guidance via CT scans, ultrasound or x-rays, which are taken immediately prior to a patient’s treatment each session. This method allows medical professionals to notice any changes in the prostate positioning since the last session, letting them adjust dosage and targeting as necessary.

So therefore the researchers on this study concluded, treatment modality did make a difference after all. According to the study’s lead author James R. Wong, M.D, who is chair of radiation oncology at Morristown Memorial Hospital what he and his co authors learned from their research has the potential to greatly improve treatment outcomes for obese prostate cancer patients. “With the results of this study, we now know that obese patients have a unique complication when it comes to planning their treatment but that we can try to correct it simply by using IGRT instead of EBRT.” he said.

Dr Wong also hopes that the publication of the findings will encourage obese patients all over the world to discuss the use of IGRT over EBRT when it comes time to start deciding upon treatment options. “All patients deserve the treatment that is going to give them the best chance at cure and survival” he concluded

The paper was published in its entirety in the September 1st Edition of the International Journal of Radiation Oncology.

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