Intraoperative Radiotherapy for Locally Advanced Prostate Cancer: Treatment Technique and Ultrasound-based Analysis of Dose Distribution

• Published in: Anticancer research Vol. 27; no. 5B; pp. 3471 - 3476
• Main Authors: ORECCHIA, Roberto, JERECZEK-FOSSA, Barbara A, SCARDINO, Epifanio, DE COBELLI, Ottavio, CIOCCA, Mario, VAVASSORI, Andrea, CAMBRIA, Raffaella, CATTANI, Federica, ZERINI, Dario, MATEI, Deliu V, ROCCO, Bernardo, VERWEIJ, Fabrizio
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01-09-2007
• Subjects: Aged; Biological and medical sciences; Humans; Intraoperative Care; Male; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - diagnostic imaging; Neoplasm Recurrence, Local - radiotherapy; Nephrology. Urinary tract diseases; Organ Size; Postoperative Care; Prostate - pathology; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - radiotherapy; Radiotherapy Dosage; Radiotherapy, Conformal; Tumors; Tumors of the urinary system; Ultrasonics; Ultrasonography; Urinary tract. Prostate gland; Dose repartition; Urinary system disease; Prostate disease; intraoperative radiotherapy; Electron beam; Intraoperative; Malignant tumor; Radiotherapy; Cancerology; Treatment; ultrasound-based dosimetry; Surgery; Prostatectomy; Advanced stage; Dosimetry; Technique; Male genital diseases; Prostate cancer; Ultrasound
• ISSN: 0250-7005; 1791-7530

Background: To present the technique and dose distribution of intraoperative radiotherapy (IORT) for prostate cancer. Patients
and Methods: Pelvic lymphadenectomy, prostate IORT and radical retropubic prostatectomy was performed in 11 prostate cancer
patients. Prostate thickness and rectum depth were measured with intraoperative ultrasound. IORT was delivered by a mobile
linear accelerator in the operating room (electron beam, 12 Gy at 90% isodose). Results: The mean preoperative probability
of organ-confined disease was 10% (Memorial Sloan Kettering Cancer Center nomograms). Mean prostate thickness, width and length
were 3.4 cm, 4.6 and 4.9 cm, respectively. Mean rectum depth was 3.3 cm. Mean doses to the posterior prostate capsule, 5-mm
lateral prostate margins and at the subsequent uretheral stump area were 4.6 Gy, 8.7 Gy and 11.3 Gy, respectively. Maximum
mean rectal dose was 4.9 Gy. Conclusion: IORT appeared a feasible approach for prostate cancer, showing a satisfactory dose
coverage to the prostate bed with relatively low rectal dose. However, high variability in dose distribution calls for further
study of patient selection criteria and dosimetry.