par Gastelblum, Pauline ;Roelandts, Martine ;Van Houtte, Paul
Référence European urology. Supplement, 5, 6, page (487-490)
Publication Publié, 2006-04
Article révisé par les pairs
Résumé : Objectives: To update the results of modern radiation therapy to treat Prostate Cancer (PCa). Methods: The authors review in the recent international literature the papers dealing with radiation therapy for PCa. They notably report on the results obtained with 3-D conformal radiotherapy, heavy ions and image guided radiotherapy (IGRT). Results: Several series have suggested a higher control rate with an increasing radiation dose: 81% for doses above 72 Gy in patients with PSA between 10 and 20 ng/ml. In 3-D conformal radiotherapy, margins are added around the clinical target volume to take into account movement of the tumour and uncertainties in the clinical target volume delineation process. IGRT allows treatment of concave forms and therefore protection of the rectal wall. Using conformal techniques, the rate of grade 2 gastrointestinal toxicity decreased from 15% to 5% and grade 3 toxicities have become rare events in the most modern series. Protons or heavy ions offer a significant advantage in dose distribution compared to photon beams but must be considered so far as investigative. At last, several randomized trials have shown that adjuvant androgen deprivation can improve the results of radical radiotherapy, especially in locally advanced PCa. Conclusions: External radiotherapy is very effective to treat localized PCa and even more locally advanced disease, especially using a conformal 3-D approach. But further improvements have still to be made for a more individualized approach. © 2006 Elsevier B.V. All rights reserved.