title: Individualized image-based lymph node irradiation for prostate cancer.
abstract: Controversy surrounds the benefit of whole pelvis radiotherapy (WPRT) over prostate-only radiotherapy (PORT) for intermediate-risk and high-risk patients with prostate cancer. In the PSA screening era, two large randomized trials as well as multiple retrospective studies comparing WPRT with PORT have been performed, albeit with contradictory results. Data regarding the use of WPRT in patients with biochemical recurrence after prostatectomy are scarce. As a consequence, the practice of WPRT varies worldwide. Advanced highly accurate imaging methods for the detection of lymph node metastases in patients with prostate cancer have been developed, such as PET, single photon emission computed tomography (SPECT), diffusion-weighted MRI and magnetic resonance lymphography (MRL). The use of these new imaging methods might improve nodal irradiation, as they can be used not only for selection of patients, but also for accurately determining the target volume to reduce geographical miss. Furthermore, these new techniques can enable dose escalation to involved lymph nodes.
authors.affiliation: Department of Radiation Oncology [875], Radboud University Nijmegen Medical Centre, P O Box 9101, 6500 HB Nijmegen, The Netherlands. h.meijer@rther.umcn.nl
authors.forename: Hanneke J M
authors.initials: HJ
authors.lastname: Meijer
authors.forename: Oscar A
authors.initials: OA
authors.lastname: Debats
authors.forename: Emile N J
authors.initials: EN
authors.lastname: Th van Lin
authors.forename: Marco
authors.initials: M
authors.lastname: van Vulpen
authors.forename: J Alfred
authors.initials: JA
authors.lastname: Witjes
authors.forename: Wim J G
authors.initials: WJ
authors.lastname: Oyen
authors.forename: Jelle O
authors.initials: JO
authors.lastname: Barentsz
authors.forename: Johannes H A M
authors.initials: JH
authors.lastname: Kaanders
mesh_terms: D003952:Diagnostic Imaging / Q000379:methods*; D018572:Disease-Free Survival; D006801:Humans; D008198:Lymph Nodes / Q000528:radiation effects*; D015182:Lymphatic Irradiation; D008207:Lymphatic Metastasis; D008297:Male; D010388:Pelvis / Q000473:pathology / Q000528:radiation effects; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy* / Q000556:secondary*; D016032:Randomized Controlled Trials as Topic / Q000379:methods