IMRT for Prostate Cancer

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« More on Radiation Therapy for Prostate Cancer Treatment

The Most Advanced External Beam Radiotherapy Available

Fox Chase's team of radiation oncologists has pioneered many of the exciting radiation treatments available today. Our doctors use IMRT to treat more patients than anywhere else in the region. Their combined experience and continuing efforts to improve this state-of-the-art treatment make our team the best in the region for IMRT.

IMRT is possible because of sophisticated computer planning. Each treatment is tailored to the individual patient. Using the CT and MRI, the physician tells the computer how much radiation to give the prostate and surrounding tissues. A computer determines the best way to deliver the treatment by varying, or "modulating," the intensity of each radiation beam. Our physicians are world experts in CT and MRI image-guided IMRT and have published journal articles and book chapters on the subject.

IMRT is delivered while the patient lies on a table in a special cast or cradle made for each man to hold his hips in an exact position. The radiation machine, or gantry, moves around the table to deliver several radiation beams at various angles.

Treatment is delivered once a day, 5 days a week, Monday through Friday (except holidays), for approximately 8 weeks. Each treatment lasts about 20-30 minutes.

Fox Chase physicians are currently studying a different way of delivering IMRT that would shorten treatment.

Precise Treatment Planning at Fox Chase

While many hospitals now offer IMRT, only a few in the nation, including Fox Chase, use the advanced planning tools that allow the most precise delivery of radiation.

Prior to treatment with IMRT, CT and MRI images are used to locate the prostate precisely allowing the radiation beam to be directed to the tumor. Because our physicians treat with high doses of radiation, it is critical to be precise and limit the amount of healthy tissues that receives radiation. MRI is the best way to image the prostate and surrounding tissues. Fox Chase was the first hospital in the nation to routinely use CT and MRI to deliver radiotherapy for every prostate cancer patient. Our physicians have extensive experience with this treatment, otherwise known as image guided radiotherapy, or IGRT.


Calypso is brand new 4-dimensional monitoring technology available at Fox Chase allows doctors to more precisely and accurately guide radiation therapy. During radiation treatment, doctors work hard to protect healthy tissues near the tumor from receiving radiation. Sometimes though, the location of the cancer moves during treatment, even if the patient is set up perfectly. This is usually caused by internal organ motion that can not be controlled by the patient or physician. For men receiving treatment for prostate cancer, the most common side effects occur when the nearby normal organs (the bladder) receive small amounts of radiation causing urinary, rectal (rectum) and sexual side effects (penile base tissues).

Since gaining FDA approval, Calypso 4D Localization System offers doctors assistance to objectively determine a tumor's location with great accuracy and continuously monitor its position throughout treatment. Miniature electromagnetic sensors (similar to seeds), called Beacon® transponders, are implanted into the prostate during treatment planning to continuously monitor position and motion of the organ in real-time. Before each treatment, Calypso finds the beacons and helps the technologist re-align the treatment plan. Unlike other treatment planning tools, Calypso offers "real time tracking" which helps improve the accuracy of delivering radiation. If the prostate moves out of the targeting range during treatment, the system signals the therapists so that an adjustment may be made.

Ultrasound Guided Targeting (BAT®)

BAT (B-mode Acquisition and Targeting) ultrasound is used everyday before treatment to direct radiation treatment. The position of the prostate shifts as the body moves. Our physicians have the most experience with ultrasound for correcting for prostate motion.

Due to the high doses of radiation delivered with IMRT, it is vital to have accurate targeting each day of treatment. BAT technology corrects for small changes in the location of the prostate between treatments. Small adjustments are made prior to each treatment using a probe placed on your stomach. This technology was developed and first used at Fox Chase Cancer Center.


See National Cancer Institute information on Prostate Cancer

CT-on-Rails is used at Fox Chase in combination with IMRT for all patients who have had their prostate removed surgically. Like BAT, CT-on-Rails is another way of correcting for small, but important, changes in the patient's positioning between treatments. Using CT-on-Rails, a CT-scan is performed immediately before each treatment and compared to the initial planning CT-scan to ensure the positioning is accurate. This is called a "CT-to-CT" matching approach. BAT may also be used.