Prostate cancer radiotherapy in kidney transplant candidates: a planning framework for defining and optimizing transplant-specific organs at risk

Description

A man awaiting a kidney transplant who develops prostate cancer creates a planning collision: radiation can cure the cancer but may scar the very tissues a transplant surgeon will need. Anna Gueiderikh and eight co-authors worked across both specialties to name those tissues: bladder dome, ureters, and the fat around the iliac vessels. They then tested whether radiotherapy plans can be steered to spare them.

Across six planning strategies, the answer split by treatment extent. For prostate-only treatment, actively optimizing for the transplant tissues cut the bladder dome's mean dose threefold or more at no cost to tumor coverage, and focused beam treatment did best of all. Once pelvic lymph nodes joined the target, doses to the critical tissues stayed high whatever the planners did. The framework argues for choosing the treatment footprint with the future transplant in view.

Catalog record

Source: https://europepmc.org/articles/PMC13214259