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Title: Pelvic Nodal Radiotherapy in Patients With Unfavorable Intermediate and High-Risk Prostate Cancer: Evidence, Rationale, and Future Directions

Abstract

Over the past 15 years, there have been three major advances in the use of external beam radiotherapy in the management of men with clinically localized prostate made. They include: (1) image guided (IG) three-dimensional conformal/intensity modulated radiotherapy; (2) radiation dose escalation; and (3) androgen deprivation therapy. To date only the last of these three advances have been shown to improve overall survival. The presence of occult pelvic nodal involvement could explain the failure of increased conformality and dose escalation to prolong survival, because the men who appear to be at the greatest risk of death from clinically localized prostate cancer are those who are likely to have lymph node metastases. This review discusses the evidence for prophylactic pelvic nodal radiotherapy, including the key trials and controversies surrounding this issue.

Authors:
 [1];  [2];  [3]
  1. The University of Texas, M. D. Anderson Cancer Center (United States)
  2. (United States)
  3. University of California San Francisco (UCSF), Helen Diller Family Comprehensive Cancer Center (United States)
Publication Date:
OSTI Identifier:
21491721
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 80; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2010.11.074; PII: S0360-3016(10)03713-2; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; NEOPLASMS; PROSTATE; RADIATION DOSES; RADIOTHERAPY; BODY; DISEASES; DOSES; GLANDS; MALE GENITALS; MEDICINE; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; THERAPY

Citation Formats

Morikawa, Lisa K., Memorial Sloan-Kettering Cancer Center, and Roach, Mack, E-mail: mroach@radonc.ucsf.ed. Pelvic Nodal Radiotherapy in Patients With Unfavorable Intermediate and High-Risk Prostate Cancer: Evidence, Rationale, and Future Directions. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2010.11.074.
Morikawa, Lisa K., Memorial Sloan-Kettering Cancer Center, & Roach, Mack, E-mail: mroach@radonc.ucsf.ed. Pelvic Nodal Radiotherapy in Patients With Unfavorable Intermediate and High-Risk Prostate Cancer: Evidence, Rationale, and Future Directions. United States. doi:10.1016/j.ijrobp.2010.11.074.
Morikawa, Lisa K., Memorial Sloan-Kettering Cancer Center, and Roach, Mack, E-mail: mroach@radonc.ucsf.ed. Sun . "Pelvic Nodal Radiotherapy in Patients With Unfavorable Intermediate and High-Risk Prostate Cancer: Evidence, Rationale, and Future Directions". United States. doi:10.1016/j.ijrobp.2010.11.074.
@article{osti_21491721,
title = {Pelvic Nodal Radiotherapy in Patients With Unfavorable Intermediate and High-Risk Prostate Cancer: Evidence, Rationale, and Future Directions},
author = {Morikawa, Lisa K. and Memorial Sloan-Kettering Cancer Center and Roach, Mack, E-mail: mroach@radonc.ucsf.ed},
abstractNote = {Over the past 15 years, there have been three major advances in the use of external beam radiotherapy in the management of men with clinically localized prostate made. They include: (1) image guided (IG) three-dimensional conformal/intensity modulated radiotherapy; (2) radiation dose escalation; and (3) androgen deprivation therapy. To date only the last of these three advances have been shown to improve overall survival. The presence of occult pelvic nodal involvement could explain the failure of increased conformality and dose escalation to prolong survival, because the men who appear to be at the greatest risk of death from clinically localized prostate cancer are those who are likely to have lymph node metastases. This review discusses the evidence for prophylactic pelvic nodal radiotherapy, including the key trials and controversies surrounding this issue.},
doi = {10.1016/j.ijrobp.2010.11.074},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 1,
volume = 80,
place = {United States},
year = {2011},
month = {5}
}