What is the role of 3-dimensional conformal radiotherapy (3D-CRT) in the treatment of prostate cancer?

Updated: Nov 29, 2018
  • Author: Isamettin Andrew Aral, MD, MS; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

In 3-dimensional conformal radiotherapy (3D-CRT), the radiation beam is shaped to include the 3-dimensional anatomic configuration of the prostate and any specified adjacent tissue (including the seminal vesicles and periprostatic adventitial tissues). 3D-CRT allows more precise delivery of therapy to the target organ or organs.

With increasing access to computed tomography (CT) and magnetic resonance imaging (MRI) simulation equipment, as well as more powerful treatment-planning equipment, the use of 3D-CRT has markedly increased over the past decade. Indeed, 3D-CRT has essentially replaced conventional external beam radiation therapy (EBRT) in the management of early-stage prostate cancer.

The transition to 3D-CRT has significantly reduced treatment-associated toxicity. More important, conforming the radiation dose to a limited target has resulted in several successful dose escalation trials. The success of 3D-CRT is the result of multiple factors, including favorable dose-response relations, increased ability to reduce radiation to neighboring normal tissue, the relative immobility of the organ (typically < 1 cm), and a high prevalence of disease.


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