Conventionally Fractionated Versus Ultrahypofractionated Radiotherapy in High-Risk Localized Prostate Cancer
Posted: Monday, January 18, 2021
Ultrahypofractionated radiation therapy has been found to yield similar treatment outcomes as conventionally fractionated radiation therapy in patients with low- and intermediate-risk prostate cancer, yet safety and efficacy have not been evaluated in patients with high-risk prostate cancer. According to Piotr Milecki II, PhD, of Poznan University of Medical Science, Poland, and colleagues, an ultrahypofractionated radiation therapy boost combined with androgen-deprivation therapy (ADT) was well tolerated and efficacious in high-risk patients with prostate cancer. The 5-year results of the HYPO-PROST trial were presented during the virtual edition of the 2020 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 128) and published in the International Journal of Radiation Oncology • Biology • Physics.
In this randomized trial, researchers compared tolerance and survival results of ultrafractionated radiation therapy with conventionally fractionated radiation therapy in patients with high-risk prostate cancer. Between January 2012 and December 2016, a total of 208 patients were included in the study. All patients were given a minimum 3 months of ADT prior to radiation treatment and then administered ADT up to 24 months. During the first phase of radiation therapy, patients received radiation to the prostate gland, seminal vesicles, and pelvic lymph nodes. In the second phase, 103 patients were randomly assigned to receive conventionally fractionated radiation therapy (15 x 2 Gy), and 105 patients received ultrahypofractionated radiation therapy (2 x 7.5 Gy).
At the 5-year endpoint, 82.9% of patients who received conventionally fractionated radiation therapy achieved biochemical relapse–free survival versus 78.2% of those who received ultrahypofractionated radiation therapy. Overall survival rates and metastases-free survival rates did not significantly differ between those who received conventionally fractionated radiation and those who received ultrahypofractionated radiation therapy (93.3% vs. 87.1% and 90.5% vs. 87.1%, respectively.) There were no statistically significant differences in late toxicities observed in either treatment group.
Disclosure: For full disclosures of the study authors, visit redjournal.org.