New RT using markers (or not)?

Dutch news reported this week on a new technique for treating PCa.
The Hospital involved in the trial is Utrecht UMC (Universitair Medisch Centrum) under RT doc Marco van Vulpen. (Hospitals in Nijmegen and Amsterdam are involved too as well as a hospital at Leuven in Belgium.)

The technique involves gold marker(s) being placed in the prostate gland to allow x-ray to locate exact position of gland prior to/during radiotherapy. (Marker is a piece of 18ct gold about 1/8th inch long and as thick as a pencil lead, worth about 60 Euros at current gold prices.)

MRI scan used to locate exact position of tumour. (This strikes me as being one new aspect.)
RT targeted at just the tumour. So collateral damage to healthy tissue around prostate is greatly reduced, it is thus expected that patients will have fewer side effects. But a much higher dose of RT is given as it is only aimed at tumour.

The treatment has so far been carried out on 180 patients; the plan is for the trial to treat 600 patients. As yet nobody has reported any bad side effects, but there is no mention of what there PSA levels are in the report.

Is this a new treatment for PCa? Or is it just a Dutch hospital catching up with what other docs are doing elsewhere in the World? Or is it a variation on other gold marker treatments?

I also wonder how the MRI scan locates where all the tumours are as there is IMO clearly a risk of there being tiny bits of tumour in a prostate that might get missed with this technique.

Alf

In passing, the news was accompanied by stats that about 5 men per thousand or 36,000 men get PCa in the Netherlands (I assume that means per year), and that about half of them are over 75. And about 15% have a family history of PCa.

I had my markers placed when I had my Bracky procedure done.

i got the tattoos and my buddy got the gold markers.  we both were treated at the same clinic about a year apart.

ed

Gold markers have been used for quite a while, usually three markers are placed so the machine can have a better target. As far as targeting only the tumor, I have never heard of that. I know that Dattoli gives more radiation to the tumor if identified, but the entire prostate is treated.

It is wise to tret the entire prostate because new research has indicated that radiation changes the DNA of prostate cells making them way less able to develop into prostate cancer in the future.

Another aspect is that I cannot imagine that this method will be suitable for all patients, if nothing else, not everyone is going to have clearly defined tumours.

Before treatment PCa is usually confirmed thanks to biopsy samples being examined under a microscope. So while lumps can often be felt during a DRE a lot of the tumour may be very small bits spread about the gland. So how do they know where it is before they do the RT.
The news story made no mention of how the docs have worked out where the tumour is. You can't stick a microscope inside the body to get inside the gland to locate everything, and as I understood it no scanning technique is yet up to it. Hence normally tjhe whole gland gets RT.