title: Progress and controversies: Radiation therapy for prostate cancer.
abstract: Radiation therapy remains a standard treatment option for men with localized prostate cancer. Alone or in combination with androgen-deprivation therapy, it represents a curative treatment and has been shown to prolong survival in selected populations. In this article, the authors review recent advances in prostate radiation-treatment techniques, photon versus proton radiation, modification of treatment fractionation, and brachytherapy-all focusing on disease control and the impact on morbidity. Also discussed are refinements in the risk stratification of men with prostate cancer and how these are better for matching patients to appropriate treatment, particularly around combined androgen-deprivation therapy. Many of these advances have cost and treatment burden implications, which have significant repercussions given the prevalence of prostate cancer. The discussion includes approaches to improve value and future directions for research.
authors.affiliation: Assistant Professor, Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
authors.forename: Neil E
authors.initials: NE
authors.lastname: Martin
authors.forename: Anthony V
authors.initials: AV
authors.lastname: D'Amico
mesh_terms: D000726:Androgen Antagonists / Q000627:therapeutic use; D001918:Brachytherapy; D019583:Dose Fractionation, Radiation; D006801:Humans; D008198:Lymph Nodes / Q000528:radiation effects; D008297:Male; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D061766:Proton Therapy; D020266:Radiotherapy, Conformal
chemical_list: D000726:Androgen Antagonists
keywords: adjuvant radiation; hypofractionation; intensity-modulated radiation therapy; prostate cancer; proton beam radiation; radiation therapy; salvage radiation