Radiotherapy for Localized and Locally Advanced Prostate Cancer

Abstract

Radiotherapeutic management encompasses all stages of prostate cancer. Conformal and intensity-modulated techniques have made possible dose-escalated external radiotherapy improving survival outcomes in localized disease and reducing toxicity in the postoperative adjuvant setting. Stereotactic techniques, under rigorous conditions, permit moderate and extreme hypofractionation which shortens the overall treatment time. In the curative setting, this can be a tool for dose escalation by taking advantage of the radiobiologic properties of prostate cancer. In the palliative setting, this allows for shorter regimens and, more importantly, re-irradiation. Finally, with the advent of transrectal ultrasonography, prostate brachytherapy has emerged as a versatile tool, either as a monotherapy in the treatment of low- or intermediate-risk disease, as a boost to external radiotherapy in high-risk disease, or as salvage treatment.