# Adaptive Salvage Radiation Therapy for Stage IIIB Prostate Adenocarcinoma Status Post-prostatectomy

## TL;DR

This paper discusses using adaptive radiation therapy to improve prostate cancer treatment after surgery by adjusting plans based on daily anatomical changes.

## Contribution

The study demonstrates the practical application of the Ethos ART system for adaptive radiation therapy in post-prostatectomy prostate cancer.

## Key findings

- Adaptive radiation therapy allows for improved treatment plans based on daily anatomical changes.
- The Ethos ART system streamlines adaptive therapy workflows for prostate cancer patients post-prostatectomy.
- Flexibility in choosing between scheduled and adapted plans enhances radiotherapy quality.

## Abstract

The prostate and post-prostatectomy surgical bed can shift in anatomical position due to changes in the bladder and rectum size. This mobility of the prostate and prostatic bed, along with that of the bladder and rectum, poses a challenge in devising a single radiation therapy plan capable of delivering the desired dose to each organ across all treatment fractions. Adaptive radiation therapy (ART) represents a significant advancement in cancer treatment. The EthosTM ART system (Varian Medical Systems, Inc., Palo Alto, CA) streamlines the adaptive therapy workflow, enabling the efficient creation of superior radiation treatment plans based on anatomical orientation at the time of treatment. This case report aims to discuss how the online ART workflow was utilized in a 72-year-old male with recurrent prostate cancer post-prostatectomy. Our results demonstrated the advantage of having the flexibility to choose between scheduled and adapted plans based on daily images, providing improved radiotherapy plan quality for prostate cancer treatment post-prostatectomy.