Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2022; 10(29): 10428-10434
Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10428
Prostate only radiotherapy using external beam radiotherapy: A clinician’s perspective
Jeong Won Lee, Mi Joo Chung
Jeong Won Lee, Department of Radiation Oncology, Daegu Catholic University School of Medicine, Daegu 42472, South Korea
Mi Joo Chung, Department of Radiation Oncology, Hanyang University Hanmaeum Changwon Hospital, Changwon 51139, South Korea
Author contributions: Lee JW performed the literatures search and drafted the manuscript; Chung MJ conceived the review and revised the manuscript; both authors have read and approved the manuscript.
Conflict-of-interest statement: All authors report no relevant conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Mi Joo Chung, MD, PhD, Assistant Professor, Doctor, Department of Radiation Oncology, Hanyang University Hanmaeum Changwon Hospital, No. 8 Yongdong-ro 57 beon-gil, Uichang-gu, Changwon 51139, South Korea.
Received: May 6, 2022
Peer-review started: May 6, 2022
First decision: August 4, 2022
Revised: August 12, 2022
Accepted: August 30, 2022
Article in press: August 30, 2022
Published online: October 16, 2022

Prostate-only radiotherapy (PORT) is widely used as the definitive treatment for localized prostate cancer. Prostate cancer has an α/β ratio; therefore, radiotherapy (RT) with a large fraction size is biologically effective for tumor control. The current external beam RT technique for PORT has been improved from three-dimensional conformal RT to intensity-modulated, stereotactic body, and image-guided RTs. These methods are associated with reduced radiation exposure to normal tissues, decreasing urinary and bowel toxicity. Several trials have shown improved local control with dose escalation through the aforementioned methods, and the efficacy and safety of intensity-modulated and stereotactic body RTs have been proven. However, the management of RT in patients with prostate cancer has not been fully elucidated. As a clinician, there are several concerns regarding the RT volume and dose considering the patient’s age and comorbidities. Therefore, this review aimed to discuss the radiobiological basis and external beam technical advancements in PORT for localized prostate cancer from a clinician’s perspective.

Keywords: Prostate cancer, Radiotherapy, Radiation dose, Radiation technique, Radiation volume

Core Tip: The present study discussed the radiobiologic basis and external beam technical advancement of prostate-only radiotherapy (PORT) for localized prostate cancer from a clinician’s perspective. We verified the efficacy and safety of PORT by external beam radiotherapy, and radiotherapy techniques are developed to deliver higher doses of radiation to prostate safely. Therefore, PORT is recommended for localized prostate cancer patients, regardless of risk groups of patients.