Hi SuzeAN,
You've probably already seen Dr. Medberry's response to your proton beam question from the CPSG board, but just for those who may be curious here it is
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Dr. Medberry
Probably the best proton series is that from the Massachusetts General Hospital. THey reported 5 year control rate of 94%, probably slightly inferior to Gamma Knife and CyberKnife. They also reported a disturbingly high rate of complications:
3.4% required a shunt for hydrocephalus
Serviceable hearing was retained in only 33% of those with hearing prior to treatment
about 10% had facial nerve dysfunction
about 10% had facial numbness or other trigeminal nerve dysfunction
Protons probably give more inhomogeneous treatment, possibly relating to the higher complicatioin rate. We would not expect to see those sorts of problems with GK or CK. MGH commented that complication rates would be lower with a lower dose, but did not report any real data, and they already have a marginal control rate.
I would get CyberKnife or Gamma Knife, and would favor the former.
Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org or cmedbery@coxinet.net
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Personally, I don't know much about this technology but I am aware that Loma Linda also utilizes it. I have seen a couple of people who had it post results over the last couple of years and unfortunately seemed to have simiilar complications to what Dr. Medberry references. At a minimum, I don't get the sense it is very proven in the treatment of AN's
Mark
