Prostate

Prostate cancer is one of the most commonly treated malignancies in radiation oncology, and radiotherapy offers effective, non-invasive options across disease stages. This chapter provides a comprehensive overview of treatment planning for prostate cancer, guiding readers from simulation through plan evaluation. Effective treatment planning depends on careful consideration of clinical intent, anatomic variability, prior treatments, and the integration of advanced imaging with consistent patient positioning, supporting accurate and reproducible delivery. Modern treatment modalities such as intensity-modulated radiation therapy, volumetric-modulated arc therapy, and stereotactic body radiation therapy are reviewed in the context of prostate cancer management. The selection of beam geometry is explored in detail, emphasizing its role in optimizing dose distributions and producing consistent outcomes. Strategies for plan optimization are presented to balance treatment efficacy with patient safety, using techniques that improve target conformity while sparing adjacent organs at risk. Methods for evaluating plan quality are outlined to ensure safety, precision, and alignment with clinical goals. Special considerations – including hip prostheses, fiducial markers, and hydrogel spacers – are addressed, highlighting their effects on imaging, dose calculation, and delivery. By integrating standardized techniques with individualized care, high-quality radiation planning supports the effective and safe management of prostate cancer.