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Title: Intraoperative Radiotherapy During Radical Prostatectomy for Locally Advanced Prostate Cancer: Technical and Dosimetric Aspects

Purpose: To analyze the feasibility of intraoperative radiotherapy (IORT) in patients with high-risk prostate cancer and candidates for radical prostatectomy. Methods and Materials: A total of 38 patients with locally advanced prostate cancer were enrolled. No patients had evidence of lymph node or distant metastases, probability of organ-confined disease >25%, or risk of lymph node involvement >15% according to the Memorial Sloan-Kettering Cancer Center Nomogram. The IORT was delivered after exposure of the prostate by a dedicated linear accelerator with beveled collimators using electrons of 9 to 12 MeV to a total dose of 10-12 Gy. Rectal dose was measured in vivo by radiochromic films placed on a rectal probe. Administration of IORT was followed by completion of radical prostatectomy and regional lymph node dissection. All cases with extracapsular extension and/or positive margins were scheduled for postoperative radiotherapy. Patients with pT3 to pT4 disease or positive nodes received adjuvant hormonal therapy. Results: Mean dose detected by radiochromic films was 3.9 Gy (range, 0.4-8.9 Gy) to the anterior rectal wall. The IORT procedure lasted 31 min on average (range, 15-45 min). No major intra- or postoperative complications occurred. Minor complications were observed in 10/33 (30%) of cases. Of the 27/31 patientsmore » who completed the postoperative external beam radiotherapy, 3/27 experienced Grade 2 rectal toxicity and 1/27 experienced Grade 2 urinary toxicity. Conclusions: Use of IORT during radical prostatectomy is feasible and allows safe delivery of postoperative external beam radiotherapy to the tumor bed without relevant acute rectal toxicity.« less
Authors:
 [1] ;  [2] ;  [1] ;  [3] ; ;  [2] ;  [1] ;  [3] ;  [1] ;  [2] ;  [4]
  1. Department of Radiotherapy, University Hospital Maggiore della Carita, Novara (Italy)
  2. Department of Urology, University Hospital Maggiore della Carita, Novara (Italy)
  3. Department of Medical Physics, University Hospital Maggiore della Carita, Novara (Italy)
  4. Department of Urology, Hospital S. Maria della Misericordia, Udine (Italy)
Publication Date:
OSTI Identifier:
21372162
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 76; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2009.03.037; PII: S0360-3016(09)00502-1; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; DOSIMETRY; LYMPH NODES; NEOPLASMS; PROSTATE; RADIATION DOSES; RADIOTHERAPY; RECTUM; SURGERY; TOXICITY BODY; DIGESTIVE SYSTEM; DISEASES; DOSES; GASTROINTESTINAL TRACT; GLANDS; INTESTINES; LARGE INTESTINE; LYMPHATIC SYSTEM; MALE GENITALS; MEDICINE; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; THERAPY