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In this study, patients with high\u2010risk PCa according to the D'Amico classification or those with cT3aN0M0 PCa were eligible. VMAT was performed using BROAD\u2010RT, and a dose of 54\u2009Gy in 15 fractions was prescribed for the prostate in combination with SIB for IPDLs at a dose of 57\u2009Gy in 15 fractions. Short\u2010term neoadjuvant androgen\u2010deprivation therapy (median: 6.9\u2009months) was conducted. Neither adjuvant androgen\u2010deprivation therapy nor fiducial marker implantation to the prostate was applied for any patient. In total, 26 patients were registered in this study between August 2018 and November 2020. Their median age was 73\u2009years at the initiation of RT. The median follow\u2010up period was 49.7\u2009months. The 4\u2010year cumulative incidence rates of grade 2 late GU and GI toxicities were 15.4 and 3.8%, respectively. No grade 3 or higher acute or late toxicities were observed. The 4\u2010year biochemical failure\u2010free survival rates were 87.7%. In conclusion, highly hypofractionated RT using BROAD\u2010RT for high\u2010risk PCa with SIB for IPDLs was feasible and facilitated favorable oncological outcomes. Therefore, this approach is considered a promising method to achieve safe dose escalation and shorten the treatment duration.<\/jats:p>","DOI":"10.1111\/cas.16429","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T07:06:44Z","timestamp":1737443204000},"page":"1004-1011","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Highly hypofractionated biaxially rotational dynamic radiation therapy (<scp>BROAD<\/scp>\u2010<scp>RT<\/scp>) for high\u2010risk prostate cancer"],"prefix":"10.1111","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7098-6221","authenticated-orcid":false,"given":"Rihito","family":"Aizawa","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology and Image\u2010Applied Therapy, Graduate School of Medicine Kyoto University  Kyoto 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