Techniques of Pelvic Irradiation

  • Ute Ganswindt
  • Claus Belka
Part of the Medical Radiology book series (MEDRAD)


Even if irradiation of pelvic lymph nodes in prostate cancer is still under debate, there is abundant evidence that a well-defined subgroup of prostate cancer patients benefit from such treatment. Thus, the management of high risk and node-positive patients has evolved significantly in the past few years. New imaging tools such as MR, PET, and sentinel procedures now allow surgeons and radiation oncologists to better target lymph nodes or nodal metastasis. Derived from surgical lymphadenectomy series, sentinel lymph node, or PET/MR imaging data, there exist precise guidelines for target volume delineation. In addition, improved radiation technologies such as IMRT and IGRT enable to deliver high-dose conformal radiation to a target volume while minimizing toxicities to normal tissues and allow differentiated dose prescriptions. In this regard, adjuvant regions (suspected microscopic involvement) are most often treated with 45–50 Gy overall dose. In cases of macroscopic lymph node involvement, overall dose on localized lymph node metastasis should be escalated to ≥60 Gy, depending on tumor volume and surrounding normal tissues. Besides conventional fractionation schemes, first series using a moderate hypo-fractionation to the prostate in combination with pelvic node irradiation was reported. The encouraging results must be validated in prospective clinical trials.


Sentinel Node Target Volume Prostate Cancer Patient Pelvic Lymph Node IMRT Technique 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of Radiation OncologyLudwig-Maximilians-University (LMU)MunichGermany

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