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Conformal radiation therapy (CRT) for the treatment of nonmetastatic prostate cancer has largely been replaced by intensity-modulated radiation therapy (IMRT) and proton therapy. However, the clinical benefit of these newer treatments is unproven.
To compare the effectiveness of radiation treatments, investigators used the Surveillance, Epidemiology, and End Results (SEER) and Medicare–linked database to examine morbidity and disease control in 15,963 patients with localized disease who were treated with CRT versus IMRT and, in a separate analysis, 684 patients who were treated with IMRT versus proton therapy. The primary outcomes were rates of gastrointestinal and urinary morbidity, hip fractures, erectile dysfunction, and additional cancer…