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To analyze the impact of intensity-modulated radiation therapy (IMRT) on high-risk prostate cancer on survival rates and radiation-induced toxicities. Between January 2003 and December 2005, 217 high-risk prostate cancer patients were treated with external beam radiation therapy (EBRT) using IMRT (n = 130) or 3-dimensional conformal radiation therapy (3D-CRT) (n = 87). Patients with Gleason score (GS) sum > 8 were grouped as high-risk prostate cancer group (n = 31), patients with GS sum ≤ 7 were grouped as low-risk prostate cancer group (n = 176). Kaplan-Meier method was used to evaluate the impact of IMRT on biochemical failure-free survival (BFFS), local recurrence-free survival (LRFS), distant recurrence-free survival (DRFS), and overall survival (OS) in the high-risk prostate cancer group. We compared grade 0-2 and 3-4 toxicities of patients in high-risk prostate cancer group treated with 3D-CRT or IMRT. In the high-risk prostate cancer group, we compared the median follow-up times between IMRT group and 3D-CRT group with Wilcoxon rank sum test. There were no differences in the 5-year BFFS (81.1% for IMRT vs. 81.3% for 3D-CRT, p = 0.781), LRFS (87.0% vs. 86.9%, p = 0.991), DRFS (85.8% vs. 85.7%, p = 0.947), and OS (85.8% vs. 84.8%, p = 0.858) between IMRT and 3D-CRT groups. IMRT did not decrease radiation-induced toxicities compared with 3D-CRT. IMRT is a good option for 82fe58eafd
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