TY - JOUR
T1 - Radiotherapy in Prostate Cancer Patients with Pelvic Lymphocele after Surgery
T2 - Clinical and Dosimetric Data of 30 Patients
AU - Jereczek-Fossa, Barbara Alicja
AU - Colangione, Sarah Pia
AU - Fodor, Cristiana
AU - Russo, Stefania
AU - Cambria, Raffaella
AU - Zerini, Dario
AU - Bonora, Maria
AU - Cecconi, Agnese
AU - Vischioni, Barbara
AU - Vavassori, Andrea
AU - Matei, Deliu Victor
AU - Bottero, Danilo
AU - Brescia, Antonio
AU - Musi, Gennaro
AU - Mazzoleni, Federica
AU - Orsi, Franco
AU - Bonomo, Guido
AU - De Cobelli, Ottavio
AU - Orecchia, Roberto
PY - 2015/8/1
Y1 - 2015/8/1
N2 - Introduction The purpose of the study was to evaluate the feasibility of irradiation after prostatectomy in the presence of asymptomatic pelvic lymphocele. Patients and Methods The inclusion criteria for this study were: (1) patients referred for postoperative (adjuvant or salvage) intensity modulated radiotherapy (IMRT; 66-69 Gy in 30 fractions); (2) detection of postoperative pelvic lymphocele at the simulation computed tomography [CT] scan; (3) no clinical symptoms; and (4) written informed consent. Radiotherapy toxicity and occurrence of symptoms or complications of lymphocele were analyzed. Dosimetric data (IMRT plans) and the modification of lymphocele volume during radiotherapy (cone beam CT [CBCT] scan) were evaluated. Results Between January 2011 and July 2013, in 30 of 308 patients (10%) treated with radiotherapy after prostatectomy, pelvic lymphocele was detected on the simulation CT. The median lymphocele volume was 47 cm3 (range, 6-467.3 cm3). Lymphocele was not included in planning target volume (PTV) in 8 cases (27%). Maximum dose to lymphocele was 57 Gy (range, 5.7-73.3 Gy). Radiotherapy was well tolerated. In all but 2 patients, lymphoceles remained asymptomatic. Lymphocele drainage - because of symptom occurrence - had to be performed in 2 patients during IMRT and in one patient, 7 weeks after IMRT. CBCT at the end of IMRT showed reduction in lymphocele volume and position compared with the initial data (median reduction of 37%), more pronounced in lymphoceles included in PTV. Conclusion Radiotherapy after prostatectomy in the presence of pelvic asymptomatic lymphocele is feasible with acceptable acute and late toxicity. The volume of lymphoceles decreased during radiotherapy and this phenomenon might require intermediate radiotherapy plan evaluation.
AB - Introduction The purpose of the study was to evaluate the feasibility of irradiation after prostatectomy in the presence of asymptomatic pelvic lymphocele. Patients and Methods The inclusion criteria for this study were: (1) patients referred for postoperative (adjuvant or salvage) intensity modulated radiotherapy (IMRT; 66-69 Gy in 30 fractions); (2) detection of postoperative pelvic lymphocele at the simulation computed tomography [CT] scan; (3) no clinical symptoms; and (4) written informed consent. Radiotherapy toxicity and occurrence of symptoms or complications of lymphocele were analyzed. Dosimetric data (IMRT plans) and the modification of lymphocele volume during radiotherapy (cone beam CT [CBCT] scan) were evaluated. Results Between January 2011 and July 2013, in 30 of 308 patients (10%) treated with radiotherapy after prostatectomy, pelvic lymphocele was detected on the simulation CT. The median lymphocele volume was 47 cm3 (range, 6-467.3 cm3). Lymphocele was not included in planning target volume (PTV) in 8 cases (27%). Maximum dose to lymphocele was 57 Gy (range, 5.7-73.3 Gy). Radiotherapy was well tolerated. In all but 2 patients, lymphoceles remained asymptomatic. Lymphocele drainage - because of symptom occurrence - had to be performed in 2 patients during IMRT and in one patient, 7 weeks after IMRT. CBCT at the end of IMRT showed reduction in lymphocele volume and position compared with the initial data (median reduction of 37%), more pronounced in lymphoceles included in PTV. Conclusion Radiotherapy after prostatectomy in the presence of pelvic asymptomatic lymphocele is feasible with acceptable acute and late toxicity. The volume of lymphoceles decreased during radiotherapy and this phenomenon might require intermediate radiotherapy plan evaluation.
KW - Adjuvant radiotherapy
KW - Lymphocele
KW - Prostatectomy
KW - Salvage radiotherapy
KW - Toxicity
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U2 - 10.1016/j.clgc.2014.11.007
DO - 10.1016/j.clgc.2014.11.007
M3 - Article
C2 - 25497586
AN - SCOPUS:84936985406
VL - 13
SP - e223-e228
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
SN - 1558-7673
IS - 4
ER -