Prostate cancer has surpassed lung cancer as the most common cancer in men.
The different treatment modalities of localized prostate cancer are:
- Radical Prostatectomy
- Radical Radiotherapy
EBRT, or Radical Radiotherapy, is a non-surgical treatment for prostate cancer using high-energy X-rays
Who is it suitable for?
Most often used in older, less fit men or as a second-line treatment, when cancer is found to have spread beyond the gland.
How to Improve RT outcome?
- Dose Escalation
- Improved Biochemical Free Survival
- Over All Survival
- ADT with EBRT
- Improved Overall Survival
How can we Escalate The Dose up to 80-90 Gy?
Proper fixation: Knee and Ankle Support devices
High Technology: IMRT or ARC Therapy
Very accurate daily setup:
- Daily reproducible bladder and rectal filling
- Daily on Board imaging with online matching (IGRT)
The first Priority in dose escalation is the Rectum
- V40 Gy < 60%, Ideally <35%
- V65 Gy < 40%
- V70 Gy 30%
- V75 Gy 10%
Advantages of RT of Localized Prostate Cancer
- Avoid surgical complications like bleeding, infection, infarction, pulmonary embolism.
- Low risk of urinary incontinence and stricture.
- Short term preservation of erectile function.
- course 8-9 weeks.
- Temporary bladder , bowel symptoms
- Probable Late erectile dysfunction.
- Salvage prostatectomy is extremely morbid.