Radiotherapy in Prostate Cancer: Innovative Techniques and Current Controversies (Medical Radiology)

Today, the arsenal of “high-precision” or “targeted” radiotherapy includes a variety of techniques and approaches that, like the pieces of a puzzle, need to be put together to provide the prostate cancer patient with high-level optimized radiation treatment. This book examines in detail the role of these innovative radiation techniques in the management of prostate cancer. In addition, a variety of current controversies regarding treatment are carefully explored, including whether prophylactic treatment of the pelvic lymphatics is essential, the magnitude of the effect of dose escalation, whether a benefit accrues from hypofractionation, and what evidence exists for the superiority of protons or heavy ions. __Radiotherapy in Prostate Cancer: Innovative Techniques and Current Controversies__ is intended for both radiation oncologists and urologists with an interest in the up-to-date capabilities of modern radiation oncology for the treatment of prostate cancer. Front Matter....Pages i-xv MR Imaging and MR Spectroscopy in Prostate Cancer....Pages 3-14 PET/CT Imaging in Prostate Cancer: Indications and Perspectives for Radiation Therapy....Pages 15-31 Target Volume Definition in Primary Prostate Cancer Radiotherapy....Pages 33-39 Value of Patient Immobilization in External Beam Radiotherapy for Prostate Cancer....Pages 41-44 Internal Immobilization: From Rectal Balloon to Hyaluronic Acid....Pages 45-51 Biochemical Recurrence: A Valuable Endpoint?....Pages 55-64 Overall- and Disease-Specific Survival in Prostata Cancer: Too Long to Wait?....Pages 65-73 Late Toxicity and Quality of Life....Pages 75-86 Dose Escalation: An Update on Randomised Clinical Trials....Pages 89-93 Intensity-Modulated Radiation Therapy for Clinically Localized Prostate Cancer....Pages 95-102 IGRT: How and When....Pages 103-107 Techniques of Pelvic Irradiation....Pages 111-122 Prophylactic Treatment of the Pelvic Lymphatics in Patients with High-Risk Prostate Cancer: Pro Radiation....Pages 123-129 Prophylactic Treatment of the Pelvic Lymphatics: Contra....Pages 131-135 Hormonal Therapy and Radiation Therapy: Randomized and Prospective Trials....Pages 137-148 Treatment of Clinically Involved Lymph Nodes....Pages 149-151 Hypo-fractionation in Prostate Cancer: Biological Aspects....Pages 155-162 Hypofractionation and Stereotactic Treatment: Clinical Data....Pages 163-172 Focal Therapy and the Index Lesion Hypothesis in Prostate Cancer....Pages 173-183 Permanent Seed Implantation....Pages 187-210 High-Dose-Rate Brachytherapy in the Treatment of Clinically Localized Prostate Cancer....Pages 211-224 Target Volume Definition in Postoperative Radiotherapy....Pages 227-230 Randomized Trials for Adjuvant Radiotherapy....Pages 231-242 Salvage Radiotherapy After Radical Prostatectomy....Pages 243-252 Salvage Prostatectomy After Radiotherapy....Pages 253-259 Proton Therapy for Prostate Cancer: Technological and Clinical Aspects....Pages 263-275 There is Evidence for the Superiority of Protons and Heavy Ions, Pro....Pages 277-289 There is Evidence for the Superiority of Protons or Heavy Ions, Contra....Pages 291-297 Radiation treatment is rapidly evolving owing to the coordinated research of physicists, engineers, computer and imaging specialists, and physicians. Today, the arsenal of ĺlhigh-precisionĺl or ĺltargetedĺl radiotherapy includes multimodal imaging, in vivo dosimetry, Monte Carlo techniques for dose planning, patient immobilization techniques, intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), biologically adapted radiotherapy (BART), quality assurance methods, novel methods of brachytherapy, and, at the far end of the scale, particle beam radiotherapy using protons and carbon ions. These approaches are like pieces of a puzzle that need to be put together to provide the prostate cancer patient with high-level optimized radiation treatment. This book examines in detail the role of the above-mentioned innovative radiation techniques in the management of prostate cancer. In addition, a variety of current controversies regarding treatment are carefully explored, including whether prophylactic treatment of the pelvic lymphatics is essential, the magnitude of the effect of dose escalation, whether a benefit accrues from hypofractionation, and what evidence exists for the superiority of protons or heavy ions. Radiotherapy in Prostate Cancer: Innovative Techniques and Current Controversies is intended for both radiation oncologists and urologists with an interest in the up-to-date capabilities of modern radiation oncology for the treatment of prostate cancer This book examines in detail the role of innovative radiation techniques in the management of prostate cancer, including IMRT, IGRT, BART, and modern brachytherap. It also explores a range of current controversies in patient treatment