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Bénéfice attendu du curage ganglionnaire et de l'exérèse des vésicules séminales pour diminuer la toxicité de la radiothérapie des tumeurs prostatiques de haut risque [Expected benefit of lymph node and seminal vesical dissection to decrease high-risk prostate cancer radiotherapy]

Résumé : Purpose 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. Patients and 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 46 Gy in the seminal vesicles and lymph nodes, and 80 Gy 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 49 Gy to 42 Gy, to 36 Gy, 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 51 Gy to 40 Gy, to 35 Gy (P < 0,05), respectively. Not irradiating the lymph nodes decreased the absolute risk of diarrhea by 11%. Conclusion Lymph node and seminal vesicle dissection before prostate cancer intensity-modulated radiotherapy allows decreasing moderately the risk of digestive toxicity. © 2016 Société française de radiothérapie oncologique (SFRO)
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-01398350
Contributor : Laurent Jonchère <>
Submitted on : Thursday, November 17, 2016 - 10:26:29 AM
Last modification on : Tuesday, February 25, 2020 - 10:01:23 AM

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J. Colliaux, L. Kharchi, S. Vincendeau, A. Simon, M. Perdrieux, et al.. Bénéfice attendu du curage ganglionnaire et de l'exérèse des vésicules séminales pour diminuer la toxicité de la radiothérapie des tumeurs prostatiques de haut risque [Expected benefit of lymph node and seminal vesical dissection to decrease high-risk prostate cancer radiotherapy]. Cancer Radiothérapie, Elsevier Masson, 2016, 20 (5), pp.347--356. ⟨10.1016/j.canrad.2016.04.006⟩. ⟨hal-01398350⟩

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