Moderator: Theodore L. Phillips, MD., University of California, San Francisco
Edward C. Halperin, MD, Duke University
There is a difference between research and therapy.
As a field, we have used research and randomized trials selectively if they show a benefit for radiation, but have dismissed its necessity when we do not have the data.
There have been a number of cases where early results from non-randomized data compared to historic controls appeared to show a benefit, but did not show a benefit after randomized testing. Examples include bone marrow transplant for breast cancer, beta-carotene for decreasing cancer incidence, hyperfractionated radiation for pediatric brain stem tumors, etc.
Non-randomized data compared to historic controls is not equal to randomized data.
The increased treatment time and monitor units due to IMRT result in higher leakage and scatter as is evidenced by the increased rate of second neoplasms with IMRT (1% vs. 1.75% at 10 years).
We must not confuse differential dose distributions with differential outcomes.
Sep 30, 2011 - Hypofractionated intensity modulated radiotherapy (IMRT) and conventional IMRT therapy are equally effective in decreasing recurrence of intermediate- to high-risk prostate cancer at five years, according to a study presented at the anual meeting of the American Society for Radiation Oncology, held from Oct. 2 to 6 in Miami Beach.