title: Low rate of lymphedema after extended pelvic lymphadenectomy followed by pelvic irradiation of node-positive prostate cancer.
abstract: BACKGROUND
  The aim of the present study was to evaluate the prevalence and severity of lower limb lymphedema after pelvic lymphadenectomy and radiotherapy to the pelvic lymph nodes in patients with prostate cancer.
  
  
  METHODS
  Twenty-six patients underwent combined treatment for high-risk node-positive prostate cancer at Skåne University Hospital between April 2008 and March 2011. The treatment consisted of extended pelvic lymphadenectomy followed by androgen deprivation therapy and radiotherapy. The pelvic lymphnodes, prostate and seminal vesicles were treated with external beam radiotherapy (EBRT) to an absorbed dose of 50 Gy followed by a brachytherapy (BT) boost of 2x10 Gy to the prostate only. Twenty-two patients accepted an invitation to a clinical examination with focus on lower limb swelling. The median time between the end of radiotherapy and examination was 2.2 years (range 1.2-4.1).
  
  
  RESULTS
  Six patients (27%) experienced grade 1 lymphedema and two patients (9%) grade 2 while none had grade 3 or 4 according to the CTC Common Toxicity Criteria scale 4.0. Three patients required treatment with compression stockings.
  
  
  CONCLUSIONS
  Brachytherapy and pelvic EBRT have a low incidence of lymphedema (at median 2.2 y after treatment) in patients with high-risk node-positive prostate cancer that have undergone pelvic lymph node dissection.
authors.affiliation: Department of Oncology, Skåne University Hospital, SE-205 02 Malmö, Sweden. elisabeth.rasmusson@med.lu.se.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Rasmusson
authors.forename: Adalsteinn
authors.initials: A
authors.lastname: Gunnlaugsson
authors.forename: René
authors.initials: R
authors.lastname: Blom
authors.forename: Thomas
authors.initials: T
authors.lastname: Björk-Eriksson
authors.forename: Per
authors.initials: P
authors.lastname: Nilsson
authors.forename: Göran
authors.initials: G
authors.lastname: Ahlgen
authors.forename: Charlotta
authors.initials: C
authors.lastname: Jönsson
authors.forename: Karin
authors.initials: K
authors.lastname: Johansson
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kjellén
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000532:radiotherapy; D008209:Lymphedema / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000150:complications* / Q000532:radiotherapy; D011832:Radiation Injuries / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects* / Q000379:methods; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D053828:Stockings, Compression; D013997:Time Factors; D016896:Treatment Outcome