In 2005 I started using the Cyberknife because of its precision and accuracy. In 2008, I literally walked out of an investors meeting for a proton center because I could not clearly see an advantage for most adult patients. (That facility later went into bankruptcy) I still review the proton data to see how I could improve my dosimetry. For example, I now limit the dose to the left atrium for my esophageal patients to reduce the risk of AF. It is easy to do without increasing the lung dose. (Red J 2024;118:124) Also the ACR guidelines allow for smaller CTVs and PTVs than used in the study. (Red J 2021 Jan1)
In 2005 I started using the Cyberknife because of its precision and accuracy. In 2008, I literally walked out of an investors meeting for a proton center because I could not clearly see an advantage for most adult patients. (That facility later went into bankruptcy) I still review the proton data to see how I could improve my dosimetry. For example, I now limit the dose to the left atrium for my esophageal patients to reduce the risk of AF. It is easy to do without increasing the lung dose. (Red J 2024;118:124) Also the ACR guidelines allow for smaller CTVs and PTVs than used in the study. (Red J 2021 Jan1)