[Modern techniques in the radiotherapy of prostate cancer. Non-surgical treatment options for localized stages].
The implementation of computer-assisted three-dimensional radiotherapy treatment planning methods based on computed tomography together with sophisticated beam modeling with individual blocks and multi-leaf-collimators in the 90's enabled the creation of steep dose gradients between the target volume and surrounding radiosensitive normal tissue. For prostate cancer, a clear dose dependence between the treated radiation dose and the treatment success is proven, especially for patients with intermediate and unfavorable prognostic criteria. However, with conventional radiotherapy, rectum and urinary bladder are limiting the applicable dose. New technical methods allow a safe dose escalation without increasing of treatment-related toxicity. An improvement in terms of PSA remission and local control was yielded. This article presents the different established external beam and interstitial treatment techniques and their clinical results.
Didinger
B
B
Radiologische Universitätsklinik, Abt. Klinische Radiologie and Deutsches Krebsforschungsforschungszentrum, Klinische Kooperationseinheit, Strahlentherapeutische Onkologie, Heidelberg. b.didinger@dfkz-heidelberg.de
Schulz-Ertner
D
D
Wannenmacher
M
M
Debus
J
J
D001918:Brachytherapy; D063193:Heavy Ion Radiotherapy; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D061766:Proton Therapy; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D020266:Radiotherapy, Conformal / Q000295:instrumentation; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D011522:Protons
D011522:Protons