POLL - For Salvage/Adjuvant Radiaition Treated Men

I had 3 little tattoos, one on each hip and one center pubic area. They are about the size of the period at the end of this sentence. They are used for rough positioning of my body while laying on the gantry of the linear accelerator. Then using the cone beam CT (CBCT) they image my anatomy each time prior to the start of radiotherapy for precise alignment. Each time the radiation technicians (which were fantastic) would make minor position alignments to compensate for bladder or rectal volumes.

Entire process took less than 7 minutes.

Only had 3 tattoos, same as Lapilot. Varian Arc machine.

Three or four tiny tattoos, a Varian Rapid-Arc LINAC. 78 Gy in 40 fractions. (full pelvic) . The last 5 or 6 fractions were called "Boost" and were focused on my prostate bed. Aiming for this boost procedure was critical and my RO was in the control room when they were performed..The hoped for cure was not achieved..

I got 3 tattoos, same as Lapilot. The hospital used the Varian Arc machine. Had 33 sessions, went 5 times a week. Radiated the prostate bed and lymph nodes. Half the time each session was spent making sure I was in the correct position,

I want to thank the 9 HW members who voted in this poll.

It allows me to go forward with SRT feeling more comfortable with the fact that my RO will not use Fiducials.

Bobby Mac

Varian arc
Three tattoos

SRT in 2008. Had 3 tiny tattoos.
Good luck.
Mag.

SRT done in 2007. Just the little tattoos. I think it was a Varian. I don't know the model, but it had an 8-track and ashtrays. (jk)

Worked out fine. Had a minor side effect that went away on its own.

My IGRT is documented in the thread linked from my sig.

Short answer, yes, 3 markers, Calypso IGRT, 2010

I talked to my RO about this. He was very aware of the UCSF study showing a 5 mm error. But, he has now stopped using fiducials for SRT. The reason was the fiducials he used (and I know there are some different brands) often didn't stay where they were put. Fiducials have little ridges to embed themselves in tissue, and they hold firm in the prostate, but they didn't hold firm when placed in the prostate bed. He found he had to site the soft tissue anyway because of that. Perhaps UCSF has a different method of placement or uses a different brand. And I don't know if any of this applies to Calypso transponders like 142 had placed.

He stressed the importance of 3 measures:
(1) Check for adequate bladder filling every time
(2) Use cone beam CT to position soft tissue (not bones, and not just tattoos) at the start of each session.
(3) Check for bowel distension every time. If it is distended, cancel the session.

(He also uses a fast machine, and CT/MRI fused images based on soft tissue landmarks)

It would be interesting to hear what UCSF says about this -- did you contact them?

I would also add the importance of adequate dosing. He gave a presentation at last week's ASTRO meeting demonstrating that 70 Gy is still on the steep part of the dose-response curve.

Hi

Igrt salvage. 42 gys to lymph nodes. 62 gys to prostate bed.

3 tattoos took about 5 to 10 min once treatment started.

35 sessions.

Failed

Best wishes
Gerry

The poll results give me a lot of comfort in knowing a large majority of men did not use fiducials. Also, Allen has confirmed his RO does not use fiducials anymore.

Bobby Mac