**6. Radiotherapy in metastatic prostate cancer**

For patients in which prostate cancer develops quickly with bony and/or other metastases and elevation of PSA, androgen deprivation is considered a therapeutic method of choice. It includes orchyectomy or TAB. Radiotherapy is considered only as palliative for painful bony metastases or threatening pathological fracture.

Radiotherapy of bony metastases is mostly performed as local therapy to involved bones but sometimes it can be applied as half-body or total-body irradiation. For solitary or

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**9. References** 

localized bony metastases radiotherapy is applied through simple fields (two opposed fields, single direct field etc). A higher daily dose of 2.5 Gy or 3 Gy is given. Single dose of 8 Gy (single shoot), 20 Gy in 5 fractions or 30Gy in 10 fractions are considered to have the same results regarding pain relief and survival.

Half-body irradiation is performed when there are many disseminated bony metastases and probably as many occult. The dose of 8 Gy is applied to lower half, and 6 Gy to upper half of the body. If we treat the whole body, the gap between irradiation of upper and lower half of the body is four weeks. (Samija et al., 1996)

On the other hand, for patients with extensive locoregional prostate cancer, radiotherapy can be applied to pelvis with a total dose of 50-60Gy in order to reduce pain, hemathuria, urethral obstruction or lymphedema (Jelić, 2005)
