Radiotherapy for prostate cancer
Shorter courses, greater precision, preserved function.
A growing challenge and an opportunity for impact
Prostate cancer affects more than 1.4 million men every year, and incidence is expected to rise by over 70% by 2040, especially in low- and middle-income countries. Each diagnosis represents a patient navigating complex choices, with his health, relationships, and quality of life in the balance.
Prostate cancer can be treated in many ways, often through surgery, radiotherapy, and systemic therapies. Across all approaches, the central challenge remains: delivering effective care while preserving what matters most.1
Incidence is expected to rise by over
by 2040 2
Proven precision, improved quality of life
Key clinical studies show that adaptive radiotherapy enables safer dose escalation, reduces toxicity, and helps preserve quality of life for prostate cancer patients.
Two fractions with MR-guided SBRT
MR-guided adaptive enables ultra-hypofractionated prostate treatment in just two sessions, with promising safety and quality of life outcomes.4
Reduced toxicity, improved quality of life
MR-guided adaptive radiotherapy lowers acute Gastrointestinal (GI)/Genitourinary (GU) side effects and improved patient-reported quality of life compared with CBCT.5
Preserved erectile function
MR-guided adaptive treatment maintains tumor control while better protecting erectile function.6
Proven tumor control with HDR brachytherapy boost
Adding an High-dose rate (HDR) brachytherapy boost to external beam radiotherapy (EBRT) achieves superior biochemical control in high-risk prostate cancer compared with EBRT alone.7, 8, 9
How adaptive radiotherapy helps you respond to clinical changes
| Your challenge | Adaptive helps you... |
| Daily variation in bladder and bowel filling | Re-optimize plans each day to compensate for prostate position shifts caused by organ filling and motion |
| Tumor regression or shifts between sessions | Adjust margins and dose distribution based on the prostate’s current anatomy |
| Critical organs (bladder, rectum, neurovascular bundles) close to the target | Safely reduce dose to organs at risk with precise daily adaptation |
| Limited clinical time and planning resources | Accelerate replanning with fast, automated plan optimization |
| Complex cases such as re-irradiation or post-op cavities | Deliver highly conformal doses with sharp dose fall-off, minimizing exposure outside the target |
Clinics are already adapting and redefining what’s possible
Cutting-edge advances in prostate cancer treatment
Dr. Alison Tree, a clinical oncologist at the Royal Marsden, highlights innovative prostate cancer treatments, emphasizing fewer hospital visits, higher doses, and improved patient experiences as the future of prostate radiotherapy.
Real-time imaging in HDR brachytherapy
Guided by clinical leaders like Dr. Alfonso Gomez-Iturriaga, our customers are advancing the standard of care in prostate cancer by confidently implementing brachytherapy, enhancing precision, outcomes, and access for patients worldwide.
Adaptive in action at DTZ Berlin
Dr. Matthias Lampe at DTZ Berlin is delivering truly precise, personalized treatments—adjusting to daily anatomical changes with precision and ease.
Nobody does adaptive like Elekta
Prostate cancer care is about balancing tumor control with quality of life. Across MR-guided and CT-guided radiotherapy and HDR brachytherapy, Elekta enables daily adaptation to organ motion and supports ultra-short treatment courses. Beyond technology, we partner with clinicians worldwide to help preserve urinary and sexual function while delivering the precision every patient deserves.
Raising the bar for outcomes and experience
The drive to improve outcomes in radiotherapy has accelerated the use of hypofractionation and stereotactic body radiotherapy (SBRT). While SBRT is established for localized low- and favourable intermediate-risk disease, evidence in high-risk or metastatic settings remains limited. For patients with high-risk to unfavourable intermediate-risk disease, and in selected salvage scenarios, multiple studies support adding a brachytherapy boost (HDR or LDR) to EBRT/SBRT to improve tumor control while respecting organs at risk.3
Advances in MR- and CT-guided adaptive radiotherapy now make it possible to personalize treatment in real-time: enhancing precision, improving flexibility, and making shorter treatment courses more accessible.
Adaptive allows you to respond to motion with confidence
Conventional radiotherapy is a proven, effective treatment for prostate cancer, offering excellent tumor control through refined planning and delivery techniques. However, the prostate is a dynamic organ, its position can shift daily or even during treatment due to bladder and rectal filling.
Adaptive radiotherapy builds on these strengths by enabling you to respond to day-to-day anatomical changes. With adaptive, you can:
Adapt to organ motion, or treat at the source
With MR- and CT-Linacs, adjust to the prostate’s position each day. HDR brachytherapy delivers dose directly inside the gland, offering inherent precision without motion concerns.
Fine-tune margins for protection
On MR- and CT-Linacs, personalize margins daily to protect the bladder, rectum, and surrounding nerves. HDR brachytherapy needs no margins, as dose is placed directly in the prostate.
Support vital functions
Across MR-Linacs, CT-Linacs and brachytherapy, treatment is tailored to the patient to help preserve continence, sexual health, and overall quality of life.
Delivering the future of prostate cancer treatment
Whether you’re treating localized, recurrent, or post-operative prostate cancer, every patient deserves care that adapts to their anatomy each day, preserving function and quality of life throughout treatment.
Adaptive radiotherapy enables shorter courses, safer dose escalation, and better protection of critical organs, without compromising tumor control. Together with our clinical partners, Elekta is shaping a new standard of precision and personalization in prostate cancer care.
Explore our adaptive solutions for prostate cancer
Our image-guided adaptive solutions help clinicians to take into account daily organ motion, protecting the bladder and rectum while maintaining treatment accuracy.
Indications
References
- 2025 Global Impact Report. Available at: https://aboutadaptive.com
(Accessed: 16 October 2025). - Cancer Tomorrow | IARC. Data version: Globocan 2022 (version 1.1) – 8 February 2024. Available at: https://gco.iarc.who.int
(Accessed: 16 October 2025). - Rodda S., Morris W.J., Hamm J. and Duncan G. (2017) ‘ASCENDE-RT: An analysis of health-related quality of life for a randomized trial comparing low-dose-rate brachytherapy boost with dose-escalated external beam boost for high- and intermediate-risk prostate cancer’, International Journal of Radiation Oncology, Biology, Physics, 98(3), pp. 581–589. Available at: https://www.redjournal.org/article/S0360-3016(25)00303-7/abstract.
- Cooper S., Westley R.L., Biscombe K. et al. (2025) ‘HERMES: Randomized trial of 2-fraction or 5-fraction magnetic resonance imaging-guided adaptive prostate radiation therapy’, International Journal of Radiation Oncology, Biology, Physics, 123(3), pp. 773–782. doi: 10.1016/j.ijrobp.2025.05.008.
- Kishan A.U., Ma T.M., Lamb J.M. et al. (2023) ‘Magnetic resonance imaging-guided vs computed tomography-guided stereotactic body radiotherapy for prostate cancer: The MIRAGE randomized clinical trial’, JAMA Oncology, 9(3), pp. 365–373. doi: 10.1001/jamaoncol.2022.6558.
- Lalmahomed T., Teunissen F., de Boer J., van Melick H., Verkooijen H., Meijer R., Wortel R. and van der Voort van Zyp J. (2025) ‘The EREctile function preservation for prostate Cancer radiation Therapy (ERECT) trial (NCT04861194): preliminary results up to 18 months’, Radiotherapy and Oncology, 206(1), pp. 1924–1925.
- Kishan A.U. and Tilki D. (2021) JAMA Oncology. Available at: https://pubmed.ncbi.nlm.nih.gov/34196715/
(Accessed: 16 October 2025); - Crook J. (2025) International Journal of Radiation Oncology, Biology, Physics. doi: 10.1016/j.ijrobp.2025.03.053. Available at: https://www.redjournal.org/article/S0360-3016(25)00303-7/abstract
(Accessed: 16 October 2025); - Kishan A.U. (2018) JAMA Oncology. Available at: https://pubmed.ncbi.nlm.nih.gov/29509865/
(Accessed: 16 October 2025).