Future Direction of Image-Guided Radiotherapy for Localized Prostate Cancer for more Precise and Conformal Treatment Delivery - Abstract
Recent technological developments in External Body Radiation Therapy (EBRT), such as intensity-modulated radiation therapy and Image-Guided Radiation Therapy (IGRT), have confirmed the advantages of delivering high doses to achieve optimal tumor-control outcomes and a significant reduction of digestive and urinary toxicities in localized prostate cancer patients. The use of fiducial markers is a reliable and accurate method to localize and register the prostate gland during EBRT. However, a number of publications have pointed out the limitations of using fiducial marker registration in IGRT for the Seminal Vesicles (SVs) when they are included in the target volumes. The SVs may become deformed and move to some extent relative to the prostate gland. In this review, several recent publications dealing with technical advances in IGRT that appear to further improve the quality of position verification methods in EBRT for localized prostate cancer are discussed. The importance of investigating the possible advantage of integrating novel systemic technologies for the improvement of outcomes of locally advanced prostate cancer patients is also examined.