Prostate cancer treatment with radiotherapy: maturing methods that minimize morbidity

Technological advances in treatment delivery and planning have provided the backdrop for an unprecedented number of options in the treatment of prostate cancer with radiotherapy. The more common choices include classical external-beam radiotherapy, external-beam radiotherapy using three-dimensional treatment planning and conformal radiotherapy (3DCRT), ultrasound-guided transperineal implant monotherapy alone or in combination with external-beam radiotherapy, and intensity-modulated radiotherapy (IMRT) techniques. This chapter reviews the data from these methods with an emphasis on dose escalation, provides comparisons with prostate-specific antigen (PSA)-era radical prostatectomy series where appropriate, and highlights future initiatives designed to further improve outcome.