Low rate of lymphedema after extended pelvic lymphadenectomy followed by pelvic irradiation of node-positive prostate cancerReportar como inadecuado




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Radiation Oncology

, 8:271

Clinical Radiation Oncology

Abstract

BackgroundThe aim of the present study was to evaluate the prevalence and severity of lower limb lymphedema after pelvic lymphadenectomy and radiotherapy to the pelvic lymph nodes in patients with prostate cancer.

MethodsTwenty-six patients underwent combined treatment for high-risk node-positive prostate cancer at Skåne University Hospital between April 2008 and March 2011. The treatment consisted of extended pelvic lymphadenectomy followed by androgen deprivation therapy and radiotherapy. The pelvic lymphnodes, prostate and seminal vesicles were treated with external beam radiotherapy EBRT to an absorbed dose of 50 Gy followed by a brachytherapy BT boost of 2x10 Gy to the prostate only. Twenty-two patients accepted an invitation to a clinical examination with focus on lower limb swelling. The median time between the end of radiotherapy and examination was 2.2 years range 1.2–4.1.

ResultsSix patients 27% experienced grade 1 lymphedema and two patients 9% grade 2 while none had grade 3 or 4 according to the CTC Common Toxicity Criteria scale 4.0. Three patients required treatment with compression stockings.

ConclusionBrachytherapy and pelvic EBRT have a low incidence of lymphedema at median 2.2 y after treatment in patients with high-risk node-positive prostate cancer that have undergone pelvic lymph node dissection.

KeywordsProstate cancer Lymphadenectomy Pelvic irradiation Node-positive Lymphedema AbbreviationsEBRTExternal beam radiotherapy

CTC 4.0Common toxicity criteria scale 4.0

BTBrachytherapy

ePLNDExtended lymphadenectomy

LNDLymph node density

RTOGRadiation therapy oncology group

HDRHigh dose rate

GnRHGonadotropin releasing hormone

RTRadiation therapy

CTVClinical target volume

PTVPlanning target volume

HTHormonal therapy

BMIBody mass index

LRVLymphedema relative volume

EDErectile dysfunction.

Electronic supplementary materialThe online version of this article doi:10.1186-1748-717X-8-271 contains supplementary material, which is available to authorized users.

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Autor: Elisabeth Rasmusson - Adalsteinn Gunnlaugsson - René Blom - Thomas Björk-Eriksson - Per Nilsson - Göran Ahlgen - Charlott

Fuente: https://link.springer.com/







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