Group	Procedure	Rating	Comments	RRL*
	External beam radiation therapy alone (EBRT)	9
	EBRT with androgen ablation	3	If more than 50% cores positive or high volume disease, then hormone therapy may be appropriate.
External Beam Pelvic Nodes Dose	4500 cGy/25 fractions	2	If more than 50% cores positive or high volume disease, may consider treating pelvic nodes.
External Beam Pelvic Nodes Dose	5040 cGy/28 fractions	2	If more than 50% cores positive or high volume disease, may consider treating pelvic nodes.
Prostate Dose (max. includes pelvic dose)	8100 cGy/45 fractions	7
Prostate Dose (max. includes pelvic dose)	7800 cGy/42 fractions	8
Prostate Dose (max. includes pelvic dose)	7560 cGy/42 fractions	7
Prostate Dose (max. includes pelvic dose)	7020 cGy/39 fractions	5
Prostate Dose (max. includes pelvic dose)	6660 cGy/37 fractions	2
Prostate Dose (max. includes pelvic dose)	< or = 5940 cGy/33 fractions	1
External Beam Treatment Plan	IMRT	8	See the ACR Appropriateness Criteria® for External Beam Radiation Therapy Treatment Planning for Clinically Localized Prostate Cancer.
External Beam Treatment Plan	Proton beam	8	See the ACR Appropriateness Criteria® for External Beam Radiation Therapy Treatment Planning for Clinically Localized Prostate Cancer.
External Beam Treatment Plan	3D-CT based plan	7	See the ACR Appropriateness Criteria® for External Beam Radiation Therapy Treatment Planning for Clinically Localized Prostate Cancer.
External Beam Treatment Plan	2D-CT based plan	3	See the ACR Appropriateness Criteria® for External Beam Radiation Therapy Treatment Planning for Clinically Localized Prostate Cancer.
External Beam Treatment Plan	Non-CT based computerized plan	2	See the ACR Appropriateness Criteria® for External Beam Radiation Therapy Treatment Planning for Clinically Localized Prostate Cancer.
Brachytherapy	LDR (permanent seeds) alone	9	See the ACR Appropriateness Criteria® for Permanent Source Brachytherapy for Prostate Cancer.
Brachytherapy	EBRT with LDR brachytherapy boost	3	See the ACR Appropriateness Criteria® for Permanent Source Brachytherapy for Prostate Cancer.
Brachytherapy	HDR (temporary implant) alone	6	See the ACR Appropriateness Criteria® for Permanent Source Brachytherapy for Prostate Cancer.
Brachytherapy	EBRT with HDR boost	3	See the ACR Appropriateness Criteria® for Permanent Source Brachytherapy for Prostate Cancer.
Nonradiation Therapy Alternatives	Radical prostatectomy (nerve sparing)	9
Nonradiation Therapy Alternatives	Cryoablation	3
Nonradiation Therapy Alternatives	Transurethral resection	2
Nonradiation Therapy Alternatives	Orchiectomy	1

Appropriateness Criteria Scale

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