Abstract
The definitive treatment of early stage prostate cancer with radiation therapy has progressed dramatically over the past two decades primarily due to the development and implementation of intensity-modulated radiation therapy (IMRT) techniques and better definition of the role of androgen deprivation therapy (ADT). IMRT has permitted the escalation of radiotherapy dose to the target tissues, namely, the prostate and proximal seminal vesicles, in an effort to improve tumor cell killing and local tumor control, while also reducing dose to nearby organs at risk (OARs) including the bladder, rectum, bowel, femoral heads, and penile bulb. Advances in image-guided radiotherapy (IGRT) have improved the accuracy of the delivery of IMRT, reduced PTV margins, and consequently decreased acute and long-term side effects. This chapter will review the clinical evidence for the use of IMRT for early stage, clinically localized (T1–2N0M0) prostate cancer and will outline the processes involved in designing and implementing a safe and effective IMRT treatment plan.