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**8** 

*Serbia* 

**Radiotherapy in Prostate Cancer** 

*Institute for Oncology and Radiology of Serbia, Institute for Urology* 

Therapeutic management of prostate cancer has become complex, multidisciplinary and stage-specific. (Heidenereich et al., 2011) Based on PSA level, histopathological grading and clinical staging, prostate cancer is classified as low-, intermediate- and high risk for disease recurrence. The risk status often plays a major role in deciding further therapy. (Kirby & Madhavan, 2010) It is usually impossible to state that one therapy is superior to another because of the lack of randomized controlled trials. However some recommendations can be made. (Heidenereich et al., 2011, Aus et al. 2001) Based on European Association of Urology recommendations in 2010, patients with low-risk (PSA ≤10 ng/ml, Gleason score <6 and cT1c-cT2a) or intermediate risk prostate cancer (PSA 10.1-20 ng/ml, Gleason score 7 or cT2b-c) are to be treated interdisciplinary with an urologist and a radiation oncologist. Treatment options for these patients vary from watchful waiting and active surveillance to radical prostatectomy or definitive radiotherapy. Multidisciplinary tumor board is needed when discussing neoadjuvant and adjuvant treatment options in high-risk prostate cancer patients (PSA>20ng/ml, Gleason

Radiotherapy is widely used as curative treatment modality for prostate cancer. There is a diverse array of radiotherapeutic strategies that can be effectively used to treat both organconfined and locally advanced disease, alone or in combination with androgen-deprivation therapy. Furthermore, it has also a significant role in post-prostatectomy setting, as adjuvant

In recent decades, radiotherapy in prostate cancer has undergone significant clinical and technological advances that aim to optimize cancer control outcomes while minimizing

External-beam radiotherapy has a very long history in the curative treatment of prostate cancer. It is proven and most extensively used radiation modality. As a flexible, noninvasive, outpatient therapy, external-beam radiotherapy can be used in all stages of prostate cancer. (Hayden et al., 2010) It is based on daily delivery of radiation to a target volume using high-energy radiation beams from linear accelerators (or cobalt machines)

score 8-10 or ≥cT3a) (Heidenereich et al., 2011, Choe & Liauw, 2010).

treatment morbidity. (Choe & Liauw, 2010, Hayden et al., 2010)

**2. External-beam radiotherapy in prostate cancer** 

**1. Introduction**

or salvage radiotherapy.

over a course of 7 to 9 weeks.

Tatjana Arsenijević, Kata Dabić Stanković, Miodrag Aćimović and Ljiljana Radošević Jelić

Tatjana Arsenijević, Kata Dabić Stanković, Miodrag Aćimović and Ljiljana Radošević Jelić *Institute for Oncology and Radiology of Serbia, Institute for Urology Serbia* 
