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Background:Image-guided radiation therapy (IGRT) is the preferred method for curative treatment of localized prostate cancer, whichcould improve disease outcome and reduce normal tissue toxicity reaction.IGRT using cone-beam computed tomography (CBCT)in combination with volumetric-modulated arc therapy (VMAT) potentially allows smaller treatment margins and dose escalationto the prostate.The aim of this study was to compare the difference of dosimetricdiffusion in conventional IGRT using 7-field,step-and-shoot intensity-modulated radiation therapy (IMRT) and hypofractionated IGRT using VMAT for patients with localizedprostate cancer.