Prostate Adenocarcinoma

  • Neil Desai
  • Michael Zelefksy


Intensity-modulated radiation therapy (IMRT) is the standard technique for external beam radiation therapy (EBRT) of prostate adenocarcinoma. Various fractionation schemes exist, and EBRT is used in both the definitive and ­post-operative settings. However, all approaches rely on accurate target delineation to realize safely the benefits of dose escalation. This chapter will describe the approach at MSKCC and provide walk-throughs of typical scenarios.


Dose Escalation External Beam Radiation Therapy Clinical Target Volume Erectile Function Digital Rectal Examination 
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Further Reading

  1. Boehmer D et al (2006) Guidelines for primary radiotherapy of patients with prostate cancer. Radiother Oncol 79(3):259–269, EORTC guidelines for definitive therapy CTV delineation, which are not particularly used in this manualPubMedCrossRefGoogle Scholar
  2. McLaughlin PW et al (2010) Radiographic and anatomic basis for prostate contouring errors and methods to improve prostate contouring accuracy. Int J Radiat Oncol Biol Phys 76(2):369–378, Excellent demonstration of the anatomic features useful in determining boundaries to the CTV and demonstrating common errors in anatomic interpretation. Particularly useful are the comparisons of MRI to CT scan imagesPubMedCrossRefGoogle Scholar
  3. Pollack A et al (2010) RTOG 0534 protocol information: a phase III trial of short-term androgen deprivation with pelvic lymph node or prostate bed only radiotherapy (SPPORT) in prostate cancer patients with a rising PSA after radical prostatectomy. See Section 6.0 Radiation Therapy. Available online at RTOG website: General approach to both the postoperative fossa and pelvic lymph nodes are demonstrated in this protocol
  4. Poortmans P et al (2007) Guidelines for target volume definition in post-operative radiotherapy for prostate cancer, on behalf of the EORTC Radiation Oncology Group. Radiother Oncol 84(2):121–127, EORT guidelines for postoperative target delineation. Note that here, we more closely approximate RTOG guidelines for therapyPubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Neil Desai
    • 1
  • Michael Zelefksy
    • 1
  1. 1.Department of Radiation OncologyMemorial Sloan-Kettering Cancer CenterNew YorkUSA

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