The 5-year distant metastasis-free survival rate was significantly lower for very high-risk patients than for intermediate-and high-risk patients (82.6% vs 99.4% and 96.5%, respectively; P < 0.01). The 5-year biochemical relapse-free survival rates significantly declined with increasing prostate cancer risk (P < 0.01), and were 95.9%, 87.2%, and 73.1% for the intermediate-risk, high-risk and very high-risk patients, respectively. Acute genitourinary and gastrointestinal toxicity grade !3 were not observed in any of the patients. Late grade 3 genitourinary toxicity occurred in 0.3% of patients. Conclusion: Combination androgen-deprivation therapy and 76-Gy intensity-modulated radiation therapy with gold marker implantation offers good therapeutic outcomes with few serious complications in patients with intermediate-and high-risk prostate cancer.