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Delineation of the Prostate Bed: The “Invisible Target” Is Still an Issue?

Author information Article notes Copyright and License information Disclaimer. This article was submitted to Genitourinary Oncology, a section of the journal Frontiers in Oncology. Received Apr 13; Accepted May The use, distribution or reproduction in other forums is permitted, provided the original author s or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice.


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World Academy of Science, Engineering and Technology

Abstract For pathological high-risk prostate cancer, adjuvant irradiation has shown a survival benefit. Introduction Radiotherapy RT after radical prostatectomy RP is indicated in the adjuvant setting for patients with high-risk pathological features 1 in the salvage setting at prostate-specific antigen PSA relapse or when the PSA remains elevated after RP 2. Definition of CTV for Prostate Bed For postoperative RT, gross tumor volume GTV does not exist clearly in adjuvant setting and it can be hardly estimated, clinically or radiologically, for salvage purpose in condition of a rising PSA because it remains microscopic most of the time.

Guidelines to Delineate the Prostate Bed Nowadays, in the literature exists at least four consensus guidelines for postoperative external beam radiotherapy for prostate cancer focusing on CTV consensus guidelines using CT, in the era of 3D-CRT: Table 1 Description of consensus guidelines. Above superior edge of symphysis pubis: More superiorly, anterior mesorectal fascia Below superior edge of symphysis pubis: Open in a separate window. Discussion The debate to promote adjuvant or SRT is still an important issue and prostate bed target delineation remains in this context difficult as location and size of recurrences can be different i.

Author Contributions IL wrote the manuscript, reviewed it, and sent it to the correspondent author; responsible for charts. Conflict of Interest Statement The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: J Urol Adjuvant and salvage radiation therapy after prostatectomy: Pathologic findings at radical prostatectomy: Urol Oncol 5: Front Oncol 7: Consensus statements on radiation therapy of prostate cancer: J Clin Oncol Radical radiation therapy in the management of prostatic adenocarcinoma: MR imaging evaluation with a transrectal surface coil of local recurrence of prostatic cancer in men who have undergone radical prostatectomy.

Local recurrence after radical prostatectomy: Suspected local recurrence after radical prostatectomy: Radiology 2: Endorectal MRI assessment of local relapse after surgery for prostate cancer: Suggestion for the prostatic fossa clinical target volume in adjuvant or salvage radiotherapy after a radical prostatectomy. Radiother Oncol 2: BJU Int 99 6: Anatomic variations due to radical prostatectomy.

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Impact on target volume definition and dose-volume parameters of rectum and bladder. Strahlenther Onkol 9: Image-guided radiotherapy using surgical clips as fiducial markers after prostatectomy: Radiother Oncol 84 2: Radiother Oncol 88 1: Anatomic boundaries of the clinical target volume prostate bed after radical prostatectomy. Development of RTOG consensus guidelines for the definition of the clinical target volume for postoperative conformal radiation therapy for prostate cancer.

Postoperative radiotherapy for prostate cancer: The normal post-surgical anatomy of the male pelvis following radical prostatectomy as assessed by magnetic resonance imaging. Eur Radiol Postoperative radiotherapy in prostate cancer: Proposal of a post-prostatectomy clinical target volume based on pre-operative MRI: Radiat Oncol 9: Local recurrence map to guide target volume delineation after radical prostatectomy.

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Pract Radiat Oncol 4 6: Cancer Radiother 18 5—6: Cancer Radiother 14 6—7: Postoperative radiotherapy for prostate cancer. Cancer Radiother 14 Suppl 1: Salvage radiotherapy with or without short-term hormone therapy for rising prostate-specific antigen concentration after radical prostatectomy GETUG-AFU Lancet Oncol 17 6: Pelvic MRI findings in relapsed prostate cancer after radical prostatectomy.

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Radiat Oncol Delineation of the postprostatectomy prostate bed using computed tomography: An interobserver study of prostatic fossa clinical target volume delineation in clinical practice: Am J Clin Oncol 34 2: Do results of the EORTC dummy run predict quality of radiotherapy delivered within multicentre clinical trials? Eur J Cancer 48 Radiother Oncol 90 3: Use of EORTC target definition guidelines for dose-intensified salvage radiation therapy for recurrent prostate cancer: Assessing the effect of a contouring protocol on postprostatectomy radiotherapy clinical target volumes and interphysician variation.

Harmonization of the volume of interest delineation among all eleven radiotherapy centers in the North of France.

PLoS One 11 3: Comparison of automated atlas-based segmentation software for postoperative prostate cancer radiotherapy. Front Oncol 6: Support Center Support Center. Please review our privacy policy. Retained seminal vesicle SV included when pathologically involved. Encompass all of the SV bed as defined by non-vascular clips and should include distal portion of the vas deferens.

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