Purpose: To determine the optimal coplanar treatment technique for six-field conformal radiotherapy of prostate only (PO) or prostate plus seminal vesicles (PSV).Methods and Materials: A series of 6-MV six-field coplanar treatment plans were created for PO and PSV volumes in 10 patients prescribed to both 64 and 74 Gy. All plans consisted of laterally-symmetric anterior oblique, lateral, and posterior oblique fields. The posterior oblique fields were varied through 20-45 o relative to the lateral fields, and for each of these angles, the anterior oblique fields were varied through 25-65 o relative to lateral. The plans were compared by means of rectal volumes irradiated to 80% or more of the prescribed dose (V 8 0 ); normal tissue complication probability (NTCP) for rectum, bladder, and femoral heads; and tumor control probability (TCP). Femoral head tolerance was designated as 52 Gy to no more than 10% volume.Results: For the PO group, anterior oblique fields at 50 o from lateral and posterior oblique fields at 25 o from lateral produced the lowest V 8 0 ,together with femoral head doses which were appropriate for most patients (V 8 0 = 24.4 +/- 5.3% [1 SD]). Compared to a commonly-used six-field (reference) plan with both anterior and posterior oblique fields at 35 o from lateral (V 8 0 = 26.3 +/- 5.9%), this represented an improvement (p = 0.001). For the PSV group, the optimal anterior and posterior oblique fields were at 65 o and 30 o from lateral, respectively (V 8 0 = 47.5 +/- 6.3%). Relative to the reference plan (V 8 0 = 49.4 +/- 5.6%), this was a marginal improvement (p = 0.07).Conclusion: The optimized six-field plans provide increased rectal sparing at both standard and escalated doses. Moreover, the gain in TCP resulting from dose escalation can be achieved with a smaller increase in rectal NTCP using the optimized six-field plans.