title: Intraoperative radiotherapy for locally advanced prostate cancer: treatment technique and ultrasound-based analysis of dose distribution.
abstract: BACKGROUND
  To present the technique and dose distribution of intraoperative radiotherapy (IORT) for prostate cancer.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Radiation Oncology, European Institute of Oncology, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Orecchia
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Jereczek-Fossa
authors.forename: Mario
authors.initials: M
authors.lastname: Ciocca
authors.forename: Andrea
authors.initials: A
authors.lastname: Vavassori
authors.forename: Raffaella
authors.initials: R
authors.lastname: Cambria
authors.forename: Federica
authors.initials: F
authors.lastname: Cattani
authors.forename: Dario
authors.initials: D
authors.lastname: Zerini
authors.forename: Deliu V
authors.initials: DV
authors.lastname: Matei
authors.forename: Bernardo
authors.initials: B
authors.lastname: Rocco
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Verweij
authors.forename: Epifanio
authors.initials: E
authors.lastname: Scardino
authors.forename: Ottavio
authors.initials: O
authors.lastname: De Cobelli
mesh_terms: D000368:Aged; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D009929:Organ Size; D011182:Postoperative Care; D011467:Prostate / Q000473:pathology; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal; D014465:Ultrasonics; D014463:Ultrasonography