Patterns of Relapse Following Radiation Therapy of Intermediate-Risk Prostate Cancer

Strategic Insights -

A recent study conducted by researchers at the Institute of Cancerology aimed to analyze the distinct relapse patterns of hypofractionated radiation therapy (HFRT) versus conventionally fractionated radiation therapy (CFRT) in patients with intermediate-risk prostate cancer (PCa). The study, published in the International Journal of Radiation Oncology*Biology*Physics, utilized data from the PROstate Fractionated Irradiation Trial (PROFIT) study, a phase 3, multicenter, randomized controlled trial. The results showed that patients who received HFRT or CFRT experienced low relapse rates, with no significant differences found between the two treatment arms in terms of local progression-free survival, pelvic lymph node metastasis-free survival, extrapelvic lymph node metastasis-free survival, or bone metastasis-free survival.

Key Takeaways:

  • The study included 274 patients with intermediate-risk prostate cancer from French and Australian centers in the PROFIT study, with a median follow-up of 6.4 years.
  • Relapse rates were low in both treatment arms, with 24.3% of patients in the HFRT arm and 19.4% of patients in the CFRT arm experiencing relapse within the 6.4-year follow-up period.
  • The median time to relapse varied by site, with 4.9 years locally, 3.96 years for pelvic lymph nodes, 2.95 years for extrapelvic lymph nodes, and 3.6 years for bone metastasis.
  • No significant differences were found between the HFRT and CFRT arms in terms of local progression-free survival, pelvic lymph node metastasis-free survival, extrapelvic lymph node metastasis-free survival, or bone metastasis-free survival.
  • The study concluded that tailored management strategies considering relapse patterns could optimize care of patients with intermediate-risk prostate cancer.
  • The study was funded by the Institute of Cancerology and had funding support from the National Cancer Institute.

Statistics:

  • 274 patients were included in the study, with 130 patients receiving HFRT and 144 patients receiving CFRT.
  • The median follow-up was 6.4 years.
  • The relapse rates were 24.3% in the HFRT arm and 19.4% in the CFRT arm.
  • The median time to relapse varied by site:

+ 4.9 years locally

+ 3.96 years for pelvic lymph nodes

+ 2.95 years for extrapelvic lymph nodes

+ 3.6 years for bone metastasis

  • No significant differences were found between the HFRT and CFRT arms in terms of local progression-free survival, pelvic lymph node metastasis-free survival, extrapelvic lymph node metastasis-free survival, or bone metastasis-free survival.

Sources:

  • Patterns of Relapse Following Radiation Therapy of Intermediate-risk Prostate Cancer In the Profit Randomized Trial. International Journal of Radiation Oncology*Biology*Physics, 2025;122(2):399-406.
  • Institute of Cancerology, Dept. of Radiation Oncology, St. Herblain, France.
  • Martin Lange, Luc Ollivier, Marion Renouf, Stephane Supiot, Loic Campion, Nicolas Magne, Igor Latorzeff, Pascal Pommier, Etienne Martin, Amaury Paumier, Guillaume Bera, Charles Catton, Jarad Martin.