The only head to head study I have seen is the ICER 2008 report comparing Seeds, IMRT, and PBT. I posted the link about
a month ago. It's a 114 page report and uses the long term Loma Linda data and compares it to Long term data on Brachytherapy and IMRT.
In short, Proton Beam had the highest biochemical relapse rate of the three, (it was slightly higher). The acute toxicity rates were similar in all three. Proton costs 3X brachytherapy, 2X IMRT and was shown to have no advantage.
Dattoli just had an article in PAACT newsletter, basically stating that PBT is ok for small cancer tumors in the brain and other areas, but does not work well on large areas such as the prostate and cannot be conformed to contours like IMRT. He goes into a lot of technical stuff saying that the surrounding tissues actually get more radiation from Proton. Dattoli of course is biased, but if you want to know the cons of Proton it's a good read.
64 years old.
PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.
2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.
Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.
Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.
25 treatments of IMRT 6 weeks after seed implants. No side affects at all.
PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.