Sometimes, intensity modulated radiation therapy is given after a patient has had a prostatectomy. There are two situations where this treatment done. In the first situation, it may be known before the surgery or discovered after the surgery, that the cancer was more extensive than expected. The cancer may have penetrated the capsule which surrounds the prostate or extended into the seminal vesicles or extend to the edge of the surgical margin. In this case, your physicians may determine in consultation that a course of IMRT to the prostate bed and surrounding tissue is needed to reduce the risk of a recurrence and kill any microscopic prostate cancer cells that may be present. The goal of adjuvant post-prostatectomy radiation therapy is to reduce the risk or eliminate a recurrence of cancer in the prostate bed.
In the second situation where IMRT is given after a prostatectomy, usually months or years have passed since the surgery before evidence of a recurrence in the prostate bed develops. This is usually discovered by a rising PSA after surgery. In this situation, treatment called salvage post-prostatectomy IMRT is given to the prostate bed and surrounding tissue to kill the recurrent prostate cancer cells. The goal of this treatment is to eradicate the prostate cancer and lower the PSA.
For both adjuvant and salvage post-prostatectomy IMRT, this treatment is given five days per week for approximately seven weeks. The planning process is similar to those patients receiving IMRT to their prostate. CT and MRI simulations are done prior to the start of treatment to plan the radiation for both adjuvant and salvage post-prostatectomy IMRT.
Daily CT scans or Calypso beacons for daily localization and tracking is used with both adjuvant salvage post-prostatectomy radiation therapy.