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Cancer research

Hypofractionated Radiotherapy for Prostate Cancer Shows Equivalent Efficacy to Conventional Radiation Therapy

Strategic Insights

— 1 min read

Research has been conducted to compare the efficacy and toxicity profiles of isodose and dose-escalated hypofractionated radiotherapy (MHFRT) to conventional fractionated radiotherapy (CFRT) for prostate cancer. The study, led by researchers from the University of California Los Angeles (UCLA), analyzed individual patient data from seven phase 3 trials comparing MHFRT to CFRT. The results show that isodose MHFRT and dose-escalated MHFRT have similar efficacy compared to CFRT, but dose-escalated MHFRT is associated with higher physician-scored and patient-reported bowel toxicity.

Key Takeaways:

  • The study analyzed individual patient data from 7 phase 3 trials comparing MHFRT to CFRT, involving 5,880 patients.
  • Isodose MHFRT and dose-escalated MHFRT have similar efficacy compared to CFRT, with no differences in progression-free survival detected.
  • Dose-escalated MHFRT is associated with higher physician-scored and patient-reported bowel toxicity, particularly grade 2 or higher gastrointestinal toxic effects.
  • Isodose MHFRT was not found to have an increased risk of urinary quality-of-life decrement or bowel quality-of-life decrement.
  • Dose-escalated MHFRT was associated with greater odds of bowel quality-of-life decrement, but no evidence of greater urinary quality-of-life decrement was found.
  • The study recommends isodose regimens, such as 60 Gy in 20 fractions, as the standard MHFRT regimen for localized prostate cancer.

Statistics:

  • 5,880 patients were involved in the 7 phase 3 trials analyzed in the study.
  • At a median follow-up of 5.4 years for isodose MHFRT and 7.1 years for dose-escalated MHFRT, no differences in progression-free survival were detected.
  • The odds of grade 2 or higher genitourinary toxic effects were not significantly higher for isodose (OR 1.16, 95% CI 0.86-1.57; p=0.32) or dose-escalated MHFRT (1.20, 0.95-1.51; p=0.13).
  • The odds of grade 2 or higher gastrointestinal toxic effects were significantly higher for dose-escalated (OR 1.48, 95% CI 1.14-1.92; p=0.0035) but not isodose MHFRT (1.30, 0.59-2.87; p=0.51).

Sources:

  • Hypofractionated Radiotherapy for Prostate Cancer (Hydra): an Individual Patient Data Meta-analysis of Randomised Trials In the Marcap Consortium. Lancet Oncology, 2025;26(4):459-469.
  • University of California Los Angeles (UCLA) Dept. of Radiation Oncology, Los Angeles, CA 90095, United States.
  • Elsevier Science Inc, Ste 800, 230 Park Ave, New York, NY 10169, USA (Elsevier - www.elsevier.com; Lancet Oncology - www.journals.elsevier.com/lancet-oncology/)

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