title: [Expected benefit of lymph node and seminal vesical dissection to decrease high-risk prostate cancer radiotherapy].
abstract: OBJECTIVE
  In case of pelvic lymph node and seminal vesicle dissection followed by prostate cancer intensity-modulated radiotherapy, the objective of the study was to evaluate the dosimetric benefit of reducing the target volume.
  
  
  METHODS
  A total of 25 patients with high-risk prostate cancer had surgery first followed by intensity-modulated radiotherapy and androgen deprivation. Four treatment planning were simulated for each patient, based on two CT scans performed before and after surgery. The target volumes were: prostate-seminal vesicles-lymph nodes, prostate-lymph nodes, prostate-seminal vesicles and prostate only. The total dose was 46Gy in the seminal vesicles and lymph nodes, and 80Gy in the prostate.
  
  
  RESULTS
  Compared to prostate target volume only, the addition of seminal vesicles and lymph nodes multiplied by a factor of 1.6 and 6.5 the target volume, respectively. Decreasing the target volume from prostate-seminal vesicles-lymph nodes to prostate-seminal vesicles, to prostate only decreased the rectal wall mean dose from 49Gy to 42Gy, to 36Gy, and the risk of late rectal bleeding from 4.4% to 3.2%, to 2.4% (P<0.05), respectively. The bladder wall mean dose decreased from 51Gy to 40Gy, to 35Gy (P<0,05), respectively. Not irradiating the lymph nodes decreased the absolute risk of diarrhea by 11%.
  
  
  CONCLUSIONS
  Lymph node and seminal vesicle dissection before prostate cancer intensity-modulated radiotherapy allows decreasing moderately the risk of digestive toxicity.
authors.affiliation: Département de radiothérapie, centre régional de lutte contre le cancer Eugène-Marquis, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France; Université de Rennes 1, centre investigation clinique, CHU Pontchaillou, 2, rue Henri-Le Guilloux, 35000 Rennes, France.
authors.forename: J
authors.initials: J
authors.lastname: Colliaux
authors.affiliation: Département de radiothérapie, centre régional de lutte contre le cancer Eugène-Marquis, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France; Inserm, U1099, laboratoire de traitement du signal et de l'image, 263, avenue du Général-Leclerc, 35042 Rennes, France.
authors.forename: L
authors.initials: L
authors.lastname: Kharchi
authors.affiliation: Service d'urologie, CHU Pontchaillou, 2, rue Henri-Le-Guilloux, 35000 Rennes, France.
authors.forename: S
authors.initials: S
authors.lastname: Vincendeau
authors.affiliation: Inserm, U1099, laboratoire de traitement du signal et de l'image, 263, avenue du Général-Leclerc, 35042 Rennes, France.
authors.forename: A
authors.initials: A
authors.lastname: Simon
authors.affiliation: Département de radiothérapie, centre régional de lutte contre le cancer Eugène-Marquis, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France.
authors.forename: M
authors.initials: M
authors.lastname: Perdrieux
authors.affiliation: Département de radiothérapie, centre régional de lutte contre le cancer Eugène-Marquis, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France.
authors.forename: É
authors.initials: É
authors.lastname: Le Prisé
authors.affiliation: Université de Rennes 1, centre investigation clinique, CHU Pontchaillou, 2, rue Henri-Le Guilloux, 35000 Rennes, France.
authors.forename: É
authors.initials: É
authors.lastname: Bellisant
authors.affiliation: Département de radiothérapie, centre régional de lutte contre le cancer Eugène-Marquis, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France; Université de Rennes 1, centre investigation clinique, CHU Pontchaillou, 2, rue Henri-Le Guilloux, 35000 Rennes, France.
authors.forename: J
authors.initials: J
authors.lastname: Castelli
authors.affiliation: Département de radiothérapie, centre régional de lutte contre le cancer Eugène-Marquis, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France; Inserm, U1099, laboratoire de traitement du signal et de l'image, 263, avenue du Général-Leclerc, 35042 Rennes, France; Université de Rennes 1, centre investigation clinique, CHU Pontchaillou, 2, rue Henri-Le Guilloux, 35000 Rennes, France. Electronic address: r.de-crevoisier@rennes.unicancer.fr.
authors.forename: R
authors.initials: R
authors.lastname: de Crevoisier
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D004307:Dose-Response Relationship, Radiation; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D058958:Organs at Risk; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D050397:Radiotherapy, Intensity-Modulated; D012007:Rectum; D012669:Seminal Vesicles / Q000601:surgery*
keywords: Cancer prostatique; Curage pelvien; IMRT; Lymph node dissection; Prostate cancer; RCMI