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The Role of Radiotherapy in the Management of Penile Cancer

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Part of the Current Clinical Urology book series (CCU)

Abstract

Squamous cell cancer of the penis is a radiocurable malignancy all too often managed by a radical surgical approach, consisting of either partial or total penectomy. Effective management of the primary tumor, while preserving penile morphology and function, has come to the forefront in multidisciplinary tertiary referral centers. In addition to more sophisticated surgical techniques, both external radiotherapy and brachytherapy have a role to play in the definitive management of the primary tumor, with 5-year penile preservation rates reported at 60 % and 85 % respectively. Given the ubiquity of high-dose rate (HDR) afterloaders in most radiotherapy departments, there is interest in transitioning from the low-dose rate brachytherapy experience to the convenience, safety, and economy of HDR brachytherapy.

Patient selection is important as the most suitable patients are those with tumor diameter <4 cm and confined to the glans. Nodal staging remains a cornerstone of management as it is the strongest predictor of survival and inguinal status subsequently determines pelvic management. Post-operative radiotherapy of the regional nodes for high-risk pathology is indicated. Chemo-radiotherapy should be considered as neoadjuvant treatment for unresectable nodes or as definitive management.

Keywords

  • Penile cancer
  • Radiotherapy
  • Brachytherapy
  • Interstitial brachytherapy
  • Surface mold radiotherapy
  • Radiotherapy management of regional lymph nodes
  • Post-operative radiotherapy
  • Combined chemo-radiotherapy
  • Penile cancer clinical trials

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Correspondence to Juanita Crook M.D., F.R.C.P.C. .

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Crook, J. (2017). The Role of Radiotherapy in the Management of Penile Cancer. In: Spiess, P. (eds) Penile Cancer. Current Clinical Urology. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-6679-0_9

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