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The optimal therapeutic intervention for men with clinically localized prostate cancer remains undefined. External beam radiotherapy is a potentially curative modality that historically has been offered to patients with intermediate- or high-risk features; more recently, radiation has been offered in combination with androgen-deprivation therapy (ADT). Evidence shows that optimizing radiotherapy dose improves outcome. With advances in conformal delivery systems, the ability to deliver higher doses more safely allows for prospective evaluation of dose escalation to improve clinical outcomes with acceptable toxicity.
From 1998 through 2002, Medical Research Council investigators conducted a prospective randomized study in 843 men (median age, …