[Radiotherapy after prostatectomy: experiences in Luxembourg from 2005 to 2006]. / Radiothérapie après prostatectomie: expérience au Luxembourg de 2005 a 2006.

Radical prostatectomy is a therapeutic option for the treatment of localized prostate cancer (T1 and T2). The prognostic factors which define risks of recurrence after prostatectomy are: capsular invasion, invasion of resection margins, seminal vesicle invasion. Two randomized trials show that adjuvant radiotherapy improves local control and biochemical recurrence-free survival. Between 2005 and 2006, 12 patients of Centre François Baclesse have been irradiated on theprostatic loge. Immediate post-operative radiotherapy was preferably used. Late toxicity (grade 1) occurred only in one patient (1 case out of 8). Based on the literature, immediate postoperative irradiation is preferentially proposed in case of unfavourable factors, or possibly used secondly, in case of biological recurrence (in early situation i.e. PSA < 0.5).

[Localized prostatic cancer: treatment exclusive by radiotherapy guided by imagery, experiences in Luxembourg in 2005 and 2006]. / Cancer localisé de la prostate: traitement par radiothérapie exclusive guideée par l'imagerie, expérience au Luxembourg en 2005 et 2006.

Exclusive radiotherapy is one of therapeutic standard in the curative treatment of localized prostate cancer. Results are equivalent when compared with other treatment regimens (radical prostatectomy or curietherapy) in localized forms. However, the patients risks profiles to predict noxious effects are different. Between 2005 and 2006, 27 patients have been treated with intensity modulated radiation therapy and image-guided radiotherapy (IGRT), after implantation of gold markers to target prostate localization during daily radiotherapy seances. The total dose of radiation delivered in prostate is 74 Gy with respect to the maximal dose defined to the rectum and to the bladder. Late toxicity was limited to grade 2 (rectitis and cystitis). These symptoms were temporary. One patient out of 20 patients with one-year follow-up experienced biological recurrence with metastasis progression. New radiotherapy technologies have allowed to reduce the incidence of the toxicity especially late rectal toxicity (2.2% in 2006) within a limited time period (one-year minimum).