Editorial Comment: Ultra-hypofractionated versus conventionally fractionated radiotherapy for prostate cancer: 5-year outcomes of the HYPO-RT-PC randomised, non-inferiority, phase 3 trial

Felipe Lott About the author

Anders Widmark 1, Adalsteinn Gunnlaugsson 2, Lars Beckman 3, Camilla Thellenberg-Karlsson 4, Morten Hoyer 5, Magnus Lagerlund 6, et al.

1 Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden; 2 Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund University, Lund, Sweden; 3 Department of Oncology, Sundsvall Hospital, Sundsvall, Sweden; 4 Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden; 5 Department of Oncology and Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark; 6 Department of Oncology, Kalmar Hospital, Kalmar, Sweden

Lancet. 2019 Aug 3;394(10196):385-395.

DOI: 10.1016/S0140-6736(19)31131-6 | ACCESS: 10.1016/S0140-6736(19)31131-6

COMMENT

Due the low alpha/beta ratio, the hypofractionation of the external radiotherapy treatment of prostate cancer can increase the therapeutic ratio and reduce the health-care cost and improve the patient comfort. It can be done by moderate hypofractionation (using 2.4 – 3.4 Gy) or by ultra-hypofractionation (at least 5 Gy per fraction) ( 11. Dasu A, Toma-Dasu I. Prostate alpha/beta revisited -- an analysis of clinical results from 14 168 patients. Acta Oncol. 2012;51:963-74.

2. Zietman AL. Making Radiation Therapy for Prostate Cancer More Economical and More Convenient. J Clin Oncol. 2016;34:2323-4.
- 33. Morgan SC, Hoffman K, Loblaw DA, Buyyounouski MK, Patton C, Barocas D, et al. Hypofractionated Radiation Therapy for Localized Prostate Cancer: Executive Summary of an ASTRO, ASCO, and AUA Evidence-Based Guideline. Pract Radiat Oncol. 2018;8:354-60. ).

This phase 3 non-inferiority randomized trial is the first to report on the efficacy and side-effects on ultra-fractionation compared with conventional and has the PSA relapse and clinical failure as primary endpoint. The most relevant secondary endpoints were the overall survival and prostate cancer-specific survival and the median follow-up time was 5yr.

The ultra-hypofractionation was non-inferior to the conventional fractionation (HR 1.002) and no significant differences were found in terms of relevant urinary or gastrointestinal toxicity.

REFERENCES

  • 1
    Dasu A, Toma-Dasu I. Prostate alpha/beta revisited -- an analysis of clinical results from 14 168 patients. Acta Oncol. 2012;51:963-74.
  • 2
    Zietman AL. Making Radiation Therapy for Prostate Cancer More Economical and More Convenient. J Clin Oncol. 2016;34:2323-4.
  • 3
    Morgan SC, Hoffman K, Loblaw DA, Buyyounouski MK, Patton C, Barocas D, et al. Hypofractionated Radiation Therapy for Localized Prostate Cancer: Executive Summary of an ASTRO, ASCO, and AUA Evidence-Based Guideline. Pract Radiat Oncol. 2018;8:354-60.

Publication Dates

  • Publication in this collection
    11 Sept 2020
  • Date of issue
    Nov-Dec 2020
Sociedade Brasileira de Urologia Rua Bambina, 153, 22251-050 Rio de Janeiro RJ Brazil, Tel. +55 21 2539-6787, Fax: +55 21 2246-4088 - Rio de Janeiro - RJ - Brazil
E-mail: brazjurol@brazjurol.com.br