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[Radiotherapy for PSA failure after prostatectomy: which volumes?]
M Bosset1, P Maingon, J F Bosset
1Service de radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, BP 77980, 21079 Dijon cedex, France. mathieu.bosset@wanadoo.fr
Summary
Radiotherapy can cure prostate cancer after prostatectomy. Defining the clinical target volume (CTV) for irradiation uses pathological findings to identify at-risk areas for relapse.
Area of Science:
- Oncology
- Radiation Oncology
- Urologic Oncology
Context:
- Post-prostatectomy radiotherapy is a potential curative treatment for recurrent prostate cancer.
- Identifying high-risk areas for biochemical relapse after prostatectomy is crucial.
- Pathological findings guide the definition of the clinical target volume (CTV).
Purpose:
- To outline the critical anatomical landmarks for defining the CTV in post-prostatectomy radiotherapy.
- To discuss the inclusion of seminal vesicles and pelvic lymph nodes in the CTV.
- To highlight the utility of surgical clips and image fusion for precise CTV delineation.
Summary:
- The CTV for post-prostatectomy radiotherapy is defined by pathological findings, limited laterally by pelvic fascia and posteriorly by the rectal anterior wall.
- The inferior CTV border encompasses the anastomosis, while the superior border corresponds to the prostatic gland length.
- Consideration of seminal vesicles, pelvic nodes, surgical clips, and preoperative imaging aids in accurate CTV definition.
Impact:
- Precise CTV delineation improves radiotherapy efficacy in managing prostate cancer recurrence.
- Standardizing CTV definition enhances treatment consistency and patient outcomes.
- Integration of advanced imaging techniques can optimize radiation targeting and minimize side effects.