Optimal treatment of patients with high-risk prostate cancer

Treatment options in subset of patients with high-risk prostate cancer are various: radical prostatectomy, hormonal therapy, radiation therapy, combined modality approach, addition of chemotherapy. Based on randomised trials data, optimal approach would consist of radical radiotherapy and long term hormonal therapy. If technically possible high dose radiotherapy, hypofractionation, image guided radiotherapy, simultaneous integrated boost on dominant intraprostatic lesion and HDR brachytherapy boost should be used as well.