How nerve-sparing technique has been applied to radiotherapy?

T introduction of nerve‐sparing technique is one of the most significant advances in the surgical treatment of prostate cancer and heralded a shift from a curing cancer at all‐cost model to a curing cancer and preserving quality of life model.1,2 In a recent article published in Lancet Oncology in May, Lee et al.3 reviewed the concept of vessel‐sparing and functional anatomy‐based radiotherapy as well as outcomes with respect to erectile dysfunction, bringing to light a conceptual shift in the management of localized prostate cancer with radiotherapy, which parallels the shift in the surgical management of prostate cancer with the introduction of nerve‐sparing technique. The hypothesis is that utilization of vessel‐sparing and functional anatomy‐based radiotherapy may result in a more personalized approach to this modality based on a patient’s specific anatomy, therefore improving patient outcomes. The concept of vessel-sparing and functional anatomy-based radiotherapy is grounded in two advantages of MRI-based planning: first, MRI can map the anatomic variation that exists among men which either allows for or prevents more targeted use of radiotherapy, and second, MRI-based planning can improve delineation of the prostate, neurovascular bundles, and vasculature compared to CT-based planning.3,4 Historically, it has been understood that radiotherapy has direct arterial effects which contribute to erectile function in addition to How nerve-sparing technique has been applied to radiotherapy?