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Advances in the Treatment of Localized Prostate Cancer: The Role of Anatomic and Functional Imaging in Men Managed With Radiotherapy

Joycelyn L. Speight, Mack Roach, III

From the Department of Radiation Oncology and Department of Urology, University of California San Francisco, Comprehensive Cancer Center, San Francisco, CA

Address reprint requests to Joycelyn L. Speight, MD, PhD, UCSF/Mt Zion Comprehensive Cancer Center, Department of Radiation Oncology, 1600 Divisadero St H1031, Box 1708, San Francisco, CA 94115-1708; e-mail speight{at}radonc17.ucsf.edu

Radiation therapy is an active modality in the management of local and regional prostate cancer, but can be curative only if all existing disease is encompassed within the treatment portal. In addition to the ability to deliver sufficient radiation dose, accurate targeting is critical to achieve better treatment outcomes. Failure to accommodate daily variations in setup and organ motion potentially limits the efficacy of sophisticated conformal techniques (three-dimensional conformal radiotherapy and intensity-modulated radiotherapy). Increased use of various online and real-time imaging techniques is an important step toward enhancing treatment accuracy. The incorporation of functional imaging techniques into treatment planning is another important step. The addition of biologic and metabolic information regarding the location and extent of disease combined with real-time online imaging will allow us to better determine where, how, and with what to treat appropriate targets and improve cure rates.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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