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7366959 
Journal Article 
Review 
Individualized image-based lymph node irradiation for prostate cancer 
Meijer, HJ; Debats, OA; Th van Lin, EN; van Vulpen, M; Witjes, JA; Oyen, WJ; Barentsz, JO; Kaanders, JH 
2013 
1 
Nature Reviews. Urology
ISSN: 1759-4812
EISSN: 1759-4820 
10 
7 
376-385 
English 
23712209 
Controversy surrounds the benefit of whole pelvis radiotherapy (WPRT) over prostate-only radiotherapy (PORT) for intermediate-risk and high-risk patients with prostate cancer. In the PSA screening era, two large randomized trials as well as multiple retrospective studies comparing WPRT with PORT have been performed, albeit with contradictory results. Data regarding the use of WPRT in patients with biochemical recurrence after prostatectomy are scarce. As a consequence, the practice of WPRT varies worldwide. Advanced highly accurate imaging methods for the detection of lymph node metastases in patients with prostate cancer have been developed, such as PET, single photon emission computed tomography (SPECT), diffusion-weighted MRI and magnetic resonance lymphography (MRL). The use of these new imaging methods might improve nodal irradiation, as they can be used not only for selection of patients, but also for accurately determining the target volume to reduce geographical miss. Furthermore, these new techniques can enable dose escalation to involved lymph nodes.