All patients undergo helical tomotherapy image-guided intensity-modulated radiotherapy beginning at the time they achieve PSA normalization (i.e., stable or declining PSA level ≤ 4 ng/mL or stable or declining PSA level ≤ pretreatment level, whichever is smaller) on two consecutive measurements taken after androgen deprivation therapy is initiated. All known metastatic sites are irradiated for 2-7 weeks during or after completion of androgen deprivation therapy.