The role of radiotherapy in urology

Radiotherapy of patients with prostate cancer offers an alternative to radi cal prostatectomy in early stages (T1-T2). In locally advanced prostate can cer a high dose or combined radiotherapy is more effective than radical sur gery with concurrent lower morbidity and mortality. Recent developments in linear accellerator technique, the progress in dose calculation and plannin g techniques provide the means to apply higher doses to a given tumor volum e while effectively protecting the surrounding normal tissue at the same ti me. These improvements may possibly reduce the rate of therapy related side effects or complications significantly. The combination of external beam r adiotherapy and interstitial brachytherapy as well as the combination of ho rmone therapy and external beam radiotherapy are most likely more effective than percutaneous irradiation alone. In special cases with a very low risk of recurrent tumor an interstitial permanent brachytherapy alone is indica ted. Future developments (i.e. intensity modulated radiotherapy - IMRT, com bined thermo-radiotherapy, proton- or neutrontherapy) may further increase the rate of curative treatments in patients with prostate cancer.