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External Beam Radiotherapy for Prostate Cancer

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Atlas of the Prostate

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Abstract

Controversies in the management of prostate cancer make treatment selection one of the most challenging areas in contemporary oncology. External beam radiotherapy (EBRT) is the one treatment modality that has applications at every stage in the natural history of carcinoma of the prostate. In early disease, it is a curative therapy that can eradicate organ-confined tumor with maximal preservation of adjacent normal tissues. Its efficacy is similar to that of surgery and its side effect profile is favorable. In the past few years, we have seen major advances in the technique of dose delivery. Three-dimensional conformal planning has become widespread and has been proven to allow safe escalation of the radiation dose and to increase disease control [1–5]. Intensity modulated radiotherapy, an advanced form of three-dimensional planning currently under study, holds promise to further improve dose distribution. Another area of intense investigation has been the use of interstitial radioactive implants, alone or in combination with EBRT. In locally advanced prostate cancer (tumor with extension beyond the confines of the glandular capsule, into the seminal vesicles, or into regional structures), EBRT combined with androgen deprivation has become the standard of care [6–9]. For those patients who have undergone surgical resection as the primary form of management, retrospective studies have identified a role for adjuvant EBRT; it provides improved local control for tumors with poor pathologic features (eg positive margins, high grade, advanced pathologic tumor stage) [10–17]. Randomized studies looking at the impact of this treatment on overall survival have now been completed; the results are awaited. EBRT also has a role in salvage therapy for patients with late local recurrences following surgery, whether detected on biochemical studies or by physical examination [14,18–21]. Finally, EBRT has a well-established role in the management of symptomatic osseous metastases, and it generally provides quick and effective pain control.

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Authors
  1. Edgar Ben-Josef
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  2. Arthur T. Porter
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Editors and Affiliations

  1. Division of Urology, University of Wisconsin-Madison Medical School, Madison, Wisconsin, USA

    Reginald C. Bruskewitz MD (Professor of Surgery) (Professor of Surgery)

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© 2003 Current Medicine, Inc.

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Ben-Josef, E., Porter, A.T. (2003). External Beam Radiotherapy for Prostate Cancer. In: Bruskewitz, R.C. (eds) Atlas of the Prostate. Current Medicine Group, London. https://doi.org/10.1007/978-1-4615-6505-5_12

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  • DOI: https://doi.org/10.1007/978-1-4615-6505-5_12

  • Publisher Name: Current Medicine Group, London

  • Print ISBN: 978-1-4615-6507-9

  • Online ISBN: 978-1-4615-6505-5

  • eBook Packages: Springer Book Archive

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