Abstract
External-beam radiation therapy of prostate cancer showed remarkable progress around the turn of the millennium - new treatment methods emerged, benefits of combined radiation and hormonal therapy were demonstrated, and treatment results improved. Treatment planning using computer-aided tomography and calculation of the spatial dose distribution launched the development of conformal techniques of radiation therapy (threedimensional conformal radiation therapy 3D-CRT, intensity-modulated radiation therapy IMRT).
Subsequent progress in imaging technologies kick-started the current era of image-guided radiation therapy (IGRT) that moved conformal methods to higher levels of quality and safety. Advanced forms of radiation therapy are associated with better dose distribution in comparison with conventional techniques, resulting in healthy tissues being spared much more substantially.
Randomized studies provided conclusive evidence for higher probability of cancer control with stronger than conventional doses of radiation. In patients with high risk prostate cancer, radiotherapy combined with neoadjuvant/adjuvant hormonal therapy resulted in better outcome than radiotherapy alone.
Randomized studies also showed that combined treatment improved not only tumour control but also overall survival rates.