放射治疗是治疗局限性前列腺癌（PCa）的主要选择之一，其肿瘤学效果与手术相似。标准化的放射治疗方法包括植入式放射治疗、少分段外部束放射治疗（EBRT）和EBRT与植入式放射治疗增强。鉴于PCa的长期存活和这些有治愈意图的放射治疗方法，晚期毒性是一个重要的考虑因素。在这个叙述性的小型综述中，我们总结了与标准治疗放射治疗方法相关的晚期毒性，包括立体定向体放射治疗，这是一种受累积证据支持的先进放射治疗技术。我们还讨论了立体定向磁共振成像引导的自适应放射治疗（SMART），这是一种新兴的模式，可能进一步提高放射治疗的治疗指数并减少晚期毒性。患者摘要：本小型综述总结了局限性前列腺癌标准和先进放射治疗技术的晚期副作用。我们还讨论了一种名为SMART的新型放射治疗方法，它可能减少晚期副作用并提高治疗效果。版权所有©2023年欧洲泌尿外科协会。由Elsevier B.V.出版。保留所有权利。

Radiotherapy is a mainstay treatment option for localized prostate cancer (PCa), with oncological outcomes similar to those with surgery. Standard-of-care radiotherapy approaches include brachytherapy, hypofractionated external beam radiotherapy (EBRT), and EBRT with brachytherapy boost. Given the long survival associated with PCa and these curative-intent radiotherapy approaches, late toxicity is a paramount consideration. In this narrative mini-review, we summarize late toxicities associated with standard-of-care radiotherapy approaches including stereotactic body radiotherapy, an advanced radiotherapy technique supported by accumulating evidence. We also discuss stereotactic magnetic resonance imaging-guided adaptive radiotherapy (SMART), an emerging paradigm that may further improve the therapeutic index of radiotherapy and reduce late toxicities. PATIENT SUMMARY: This mini-review summarizes late side effects associated with standard and advanced radiotherapy techniques for localized prostate cancer. We also discuss a new radiotherapy approach called SMART that may reduce late side effects and increase treatment effectiveness.Copyright © 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.