EUS-guided fiducial placement after radical prostatectomy before targeted radiation therapy for prostate cancer recurrence

Abstract

Intensity-modulated radiotherapy (IMRT) is a modality of image-guided radiation therapy that allows the delivery of high treatment doses while minimizing the effects on adjacent organs. IMRT is well-tolerated, with similar or less toxicity than 3-dimensional conformal radiotherapy. IMRT, however, requires the placement of fiducial markers to guide treatment delivery. Fiducials are particularly important in patients after radical prostatectomy because of the lack of a definitive target. Challenges also exist in clearly delineating the prostate bed because of postsurgical anatomical changes, such as shortening of the urethra.