Between April 1996 and January 2000, 561 patients with a median age of 68 (ranging from 46 to 86 years old) were treated with IMRT, an improved form of three-dimensional conformal radiation therapy (3D-CRT), also used in radiotherapy. IMRT uses enhanced planning treatment software that more precisely targets the prostate, allowing the beam of radiation to deliver a high dose (81 Gy) to the tumor target while sparing the adjacent bladder and rectum from exposure to the higher amounts of radiation. Perhaps because of this, the eight-year results show urinary continence was maintained for all patients, and only 1.6 percent of the five hundred sixty-one patients experienced rectal bleeding. The high-dose radiotherapy was curative for the majority of the patients in all three prognostic risk groups, with 89 percent of the favorable, 78 percent of the intermediate, and 67 percent of the unfavorable group alive after an average period of eight years. Of those men who were potent prior to IMRT, erectile dysfunction developed in 49 percent.
"This study confirms that we can improve patients' quality of life by reducing the side effects of radiotherapy while maintaining disease-free survival," said Dr. Zelefsky. "However, there is still room for improvement. We are incorporating image-guided approaches that may continue the excellent tumor control but further limit the area we are irradiating and reduce side-effects."