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Sandy Srinivas, MD
Sandy Srinivas, MD
Posted: Thursday, November 10, 2022
The phase III PCS5 trial, presented at the 2022 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 4), highlighted findings on the effects of hypofractionated radiotherapy in high-risk patients with prostate cancer. Tamim. M. Niazi, MD, of McGill University, Montreal, and colleagues compared the effects of conventionally versus hypofractionated radiation therapy in the high-risk population and found no significant differences between the groups in all established study endpoints.
“I think this trial will pave the way for patients with high-risk prostate cancer to be treated in 5 weeks instead of 8 weeks,” stated Dr. Niazi in an ASTRO press release. “Survival rates and side effects, both short-term and long-term, were similar with moderately shortened radiation therapy.”
A total of 329 patients were initially included in this Canadian multicentric, noninferiority trial. However, 159 and 160 men were included in survival analyses for the hypofractionation and conventional arms, respectively. Patients in the conventional group received 76 Gy in 2 Gy per fraction to the prostate, where 46 Gy was delivered to the pelvic lymph nodes; patients in the hypofractionation arm received a concomitant dose escalation of 68 Gy in 2.72 Gy per fraction to the prostate and 45 Gy in 1.8 Gy per fraction to the pelvic lymph nodes.
Overall findings revealed that at 7-year follow-up, there were no significant differences in overall mortality between the groups (81.7% vs. 82%; hazard ratio [HR] = 0.92 [0.56–1.53]; P = .76). There were also no differences in prostate cancer–specific mortality (94.9% vs. 96.4%; HR = 1.31 [0.46–3.78]; P = .61), or disease-free survival (86.5% vs. 83.4%; HR = 0.82 [0.47–1.46]; P = .50). Additionally, there were no significant differences in grade 3 or higher acute and delayed genitourinary and gastrointestinal toxicities at 2-year follow-up or any point thereafter. Based on these comparable findings, the study authors concluded that hypofractionated therapy should be considered as a new standard of care for patients with high-risk prostate cancer.
Disclosure: For full disclosures of the study authors, visit plan.core-apps.com.
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