Re: Proton Information

[Guest guest]

, here we go again. You know me well enough to know that I cannot let that last post go unanswered. The tone and message was rude and discoourteous. Once again I state categorically that I in no way am interested in "marketing" proton therapy.

So here goes:

Dr. Chodak:

Please review this:

http://jama.ama-assn.org/cgi/content/full/294/10/1233

Please note that this is NOT a "pro-proton" study, but is a trial to determine if proton dose escalation is a reasonable way to proceed. The thing to recognize is that the study reports data that DOES indicate that proton therapy is a reasonable treatment to consider with all the others. Note the following first sentence under "Comment." (Emphasis below is mine)

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"Although this trial validates the use of proton-beam therapy, it did not test whether this modality is more or less efficacious than other less expensive and more commonly available conformal techniques or, for that matter, than brachytherapy or surgery.[References] 15, 26-27

Nor do the results justify using doses above 79 Gy outside the context of a clinical trial.

In summary, this randomized controlled trial shows an advantage to high-dose over conventional-dose conformal radiation in terms of freedom from biochemical failure for men with low- and intermediate-risk prostate cancer. This advantage was safely achieved with only a small increase in grade 2 rectal morbidity and no increase in GU morbidity by the use of highly conformal radiation techniques that included 3-dimensional photon and proton beams."

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Dr. Chodak, do you recognize Dr. Zeitman's credentials? Note that he doesnt even recommend protons for prostate cancer now, (he recommends IMRT, apparently because he believes the proton system at MGH is better used to treat other cancers.) But I think you can believe this data, and please note that the "five year data" issue you say is not available is addressed. Also there are plenty of "published" references here. Please do not argue the methods used in the report here; if you disagree, write the authors of the article. Note also that the errors are noted in the follow-up.

My point is that published peer-reviewed references do exist that indicate proton therapy is a recognized and established treatment. New studies will continue to be published as the new centers come on-line which will add to the existing database. Proton therapy as a treatment modality therefore should be carefully examined. Those of us that have experienced it can and do testify to the minimal side effects.

And you can put this in thebank: This is my last post referencing Dr. Chodak or his comments.

Fuller

>> It seesm you are quite invested in promoting proton even to the point of citing information that is neither published, nor validated. This reference is not from a published study, does not at all describe how the data are collected and again does not talk about survival. I am certain you will keep promoting this but it is because of this kind of inadequate information that many well respected prostate cancer specialists other than myself are concerned about the marketing of this method without providing anyone with information that can be analyzed like other treatments can. This is not about being against proton but being against misinformation. This is so self-serving, it is sad to see.> > > >