Radiation Therapy Techniques and Dose Selection in the Treatment of Prostate Cancer.

A dose response for local control of cancer of the prostate is shown, and normal tissue irradiated volume and complications are diminished with conformal radiation therapy techniques in prostate cancer. Refinements in techniques and technology, as well as phase II trials are underway. Should these studies prove dose escalation to be safe, a phase III trial comparing standard techniques and dose with conformal high dose radiotherapy is warranted for patients with adenocarcinoma of the prostate. If a phase III study is positive, then it will confirm that local control of prostate cancer can be improved with conformal therapy techniques without increasing the morbidity of treatment. However, if this is proven to be true only for institutions with highly specialized equipment, then this finding will have very little impact on the total treatment of prostate cancer or consequences of this disease. A truly successful trial will produce results that can be duplicated in modern radiation therapy centers that have conscientiously maintained current, but not necessarily esoteric technology; it is in the best interests of our patients and our colleagues to develop treatment technologies that can be implemented at all institutional strata.