title: May intra-operative radiotherapy have a role in the treatment of prostate cancer?
abstract: Treatment of locally advanced prostate cancer is still a challenge. Combined treatments including hormone therapy, radiotherapy, and/or surgery can achieve less than 50% of disease free survival at 10 years. Almost 50% of patients with locally advanced disease after radical prostatectomy experience local relapse and biochemical failure occurs up to 70% of cases after radiotherapy and hormone therapy. Postoperative radiotherapy has recently demonstrated to improve biochemical and clinical outcome in pT3 and/or positive margin tumors in 3 large randomized trials. Therefore, combining surgery and intra-operative radiotherapy (IORT) might be of value in this patient population. Recently, a number of studies have shown the feasibility of IORT, delivered with dedicated linear accelerators, combined or not with external beam radiotherapy with the aim of improving clinical outcome and possibly shortening overall treatment time. Preliminary clinical results look encouraging and could be the premise for future controlled prospective phase III trials.
authors.affiliation: Department of Radiotherapy, University Hospital Maggiore della Carità and University of Piemonte Orientale, Novara, Italy. krengli@med.unipmn.it
authors.forename: Marco
authors.initials: M
authors.lastname: Krengli
authors.forename: Carlo
authors.initials: C
authors.lastname: Terrone
authors.forename: Barbara Alicja
authors.initials: BA
authors.lastname: Jereczek-Fossa
authors.forename: Debora
authors.initials: D
authors.lastname: Beldì
authors.forename: Roberto
authors.initials: R
authors.lastname: Orecchia
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy / Q000379:methods*; D018572:Disease-Free Survival; D005720:Gamma Rays / Q000627:therapeutic use*; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D009367:Neoplasm Staging; D011446:Prospective Studies; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012008:Recurrence