Radiotherapy Techniques in Prostate Cancer Management
Summary
Radiotherapy has evolved into a cornerstone of prostate cancer treatment, offering curative potential for localised disease and an integral role in multimodal management of higher risk presentations. Conventional external-beam radiotherapy employs photon beams delivered over multiple weeks, while intensity-modulated radiotherapy (IMRT) and volumetric arc therapy (VMAT) refine dose conformity to the prostate, sparing adjacent structures. Hypofractionation regimens shorten overall treatment by delivering larger doses per fraction, capitalising on the tumour’s radiobiological sensitivity. Stereotactic body radiotherapy (SBRT) delivers ultrahypofractionated high-dose treatments in five or fewer sessions, with steep dose gradients and enhanced precision. Image guidance has progressed from planar X-rays and cone-beam CT to real-time magnetic resonance guidance, enabling adaptive planning and real-time motion tracking. Dose escalation strategies target improved biochemical control but require meticulous modulation of margins to limit genitourinary and gastrointestinal toxicity. Recent advances in intrafraction motion management and online adaptive planning have further individualised treatments, with global implementation supported by robust clinical data demonstrating both oncological efficacy and acceptable safety profiles.
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Radiotherapy Techniques in Prostate Cancer Management publication trend
The graph below shows the total number of articles in radiotherapy techniques in prostate cancer management across all publications each year (not limited to Nature Index journals).
Technical terms
Stereotactic Body Radiotherapy (SBRT): A high-precision technique delivering very high radiation doses in five or fewer fractions, minimising overall treatment time.
Intensity-Modulated Radiotherapy (IMRT): An advanced form of external-beam radiotherapy that modulates beam intensity to conform dose to the target while sparing surrounding healthy tissue.
Hypofractionation: A radiotherapy schedule in which larger doses per session are delivered over fewer sessions compared with conventional fractionation.
Magnetic Resonance-guided Radiotherapy (MRgRT): Integration of MRI into the treatment unit to provide superior soft-tissue contrast for real-time imaging and adaptive planning.
Intrafraction Motion: Movements of the prostate during a single treatment session, managed through imaging and tracking to ensure accurate dose delivery.
References
- Magnetic Resonance Imaging–Guided vs Computed Tomography–Guided Stereotactic Body Radiotherapy for Prostate Cancer. JAMA Oncology (2023).
- Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: 5-year outcomes of the randomised, non-inferiority, phase 3 CHHiP trial. The Lancet Oncology (2016).
- Intensity-modulated radiotherapy versus stereotactic body radiotherapy for prostate cancer (PACE-B): 2-year toxicity results from an open-label, randomised, phase 3, non-inferiority trial. The Lancet Oncology (2022).
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