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The objective of this work was to assess the overall survival, cause-specific survival and biochemical failure-free survival of a contemporary cohort of patients with localized prostate cancer (PCa) treated with intensity-modulated radiation therapy (IMRT) or radical prostatectomy (RP).
As for RP, surgical techniques have been added, such as the preservation of the neurovascular bundles and laparoscopy or robotic surgery to improve outcomes and decrease complications. Radiotherapy has advanced towards intensity-modulated radiation therapy (IMRT). IMRT is a new technique that modulates the radiation beam so that it achieves a more conformal dose distribution to the target and spare more normal tissues Thus, in PCa, IMRT allows an increase of the prostate radiation dose and reduces toxicity in the rectum and bladder. Sheets et al.  showed that increasing the radiation dose improves recurrence-free survival and furthermore concluded that IMRT had fewer gastrointestinal side effects and lower rates of hip fracture than conventional RT. There are several inconclusive systematic reviews comparing radiation treatments [11, 12]. However, according to a recent review by Bauman et al. , which included 11 studies with over 4500 patients, IMRT would have an advantage over three-dimensional conformal RT (3DCRT) in localized PCa requiring more than 70 Gy, and therefore should become the treatment of choice for these patients. Thus, 3DCRT has largely been supplanted by IMRT as the external beam radiation technique of choice. In 2000, 0.15% of treatments were carried out using IMRT compared with 95.9% in 2008 .
To our knowledge, there is only one study comparing IMRT and RP , since most studies compare RT (without specifying the RT technique) with surgery. Therefore, our objective was to assess outcomes such as overall survival (OS), cause-specific survival (CSS), mortality from other causes (MOC) and biochemical disease-free survival (BDFS) in a contemporary cohort of over one thousand patients with localized PCa treated with IMRT or RP in a Chilean population. 2b1af7f3a8