Providing State-of-the-Art Treatment for Prostate Cancer at TGH OncoLife: The Advantage of Synchrony^TM

TGH OncoLife Cancer Centre, located in Talegaon Dabhade, Pune, is led by Dr. Jyoti Mehta, MD, who specialises in radiation oncology and is a member of the FICO.

The reason we are here

In India, prostate cancer is one of the top ten most common cancers. It is primarily affecting men aged 65 and older, but we are also seeing younger patients in metropolitan areas. This makes precision more important than it has ever been, as it allows for effective treatment of the tumour while also protecting the function of the bladder, bowel, and sexual organs. IGRT that is based on synchrony is designed to achieve such precision.

To put it another way, what exactly is the Synchrony-based IGRT?

This method of radiotherapy is a sophisticated approach that monitors the prostate in real time and moves the beam in tandem with it. While the patient is undergoing treatment (breathing, bowel/bladder filling), the prostate may undergo a slight movement. By maintaining the target in the centre, synchrony ensures that healthy tissues receive a lower dose while the tumour receives precisely what is intended. You can think of it as a camera gimbal that maintains focus on the subject even if it is moving.

Why patients benefit from this

Even when the prostate is moving, pinpoint accuracy is maintained.

Fewer adverse effects by sparing the organs in the surrounding area

Sessions that are effective and include steady and consistent targeting

When precision is maintained throughout the care process, the long-term outcomes are improved.

A true story, told in a straightforward manner

The patient is a 62-year-old male from Solapur who is experiencing symptoms related to the lower urinary tract.

Prostate adenocarcinoma with an intermediate risk of progression is the diagnosis.

First step: the team’s plan Leuprolide 22.5 mg every three months commenced as part of the hormonal therapy regimen.

In the second step, gold fiducial markers were positioned under the guidance of an ultrasound by an interventional radiologist. The procedure was performed in sterile conditions, and the patient’s consent was obtained in great detail.

Map and track is the third step. After a period of two weeks, the simulation and planning for Synchrony were completed.

IGRT with Synchrony to a total dose of 66 Gy in 28 fractions is the treatment that is administered in the fourth step (Phase I: 56 Gy/25; Phase II: 10 Gy/3 to specifically target the prostate).

Tolerance: There were no symptoms of side effects or gaps in treatment reported. This is exactly how the patient should feel when they are receiving precision medicine: effective and unobtrusive.

The patient’s journey, broken down into phases

Multidisciplinary discussion confirms the risk group and the plan during the consultation and staging process.

Hormone therapy, if indicated, can reduce the size of the disease and control it before or during therapy.

Small gold markers, known as fiducial placement, function similarly to “GPS tags” regarding the prostate.

We establish tracking rules and model the motion of the prostate as part of our synchrony simulation and planning.

IGRT with Synchrony uses a beam that follows the gland in real time, ensuring that the accuracy is maintained while maintaining a low dose to normal tissue.

Aftercare: Monitor the patient’s recovery, urinary and bowel function, and PSA; make any necessary adjustments to the ongoing care.

For the press conference, here are some talking points.

Recent developments include the implementation of Synchrony on our TomoTherapy platform, which enables real-time motion tracking for prostate radiotherapy.

Why it is important: increased precision leads to fewer adverse effects; treatment that takes into account the patient’s quality of life.

A 62-year-old patient with an intermediate risk completed 66 Gy/28 of radiation therapy without experiencing any treatment gaps or adverse effects.

Our commitment is to provide protocols that are supported by evidence, careful counselling (including the placement and preparation of fiducials), and compassionate follow-up.