This manuscript reviews the clinical evidence for hypofractionation in prostate cancer, focusing on data from prospective trials.
For the purposes of this manuscript, we categorize hypofractionation as moderate (2.4-4 Gy per fraction) or extreme (6.5-10 Gy per fraction). Five randomized controlled trials have evaluated moderate hypofractionation in >1500 men, with most followed for >4-5 years. The results of these randomized trials are inconsistent. No randomized trials or other rigorous comparisons of extreme hypofractionation with conventional fractionation have been reported. Prospective single-arm studies of extreme hypofractionation appear favorable, but small sample sizes preclude precise estimates of efficacy and short follow-up prevents complication estimates beyond 3-5 years. Over the next several years, the results of 3 large noninferiority trials of moderate hypofractionation and 2 randomized trials of extreme hypofractionation should help clarify the role of hypofractionation in prostate cancer therapy.
Written by:
Cabrera AR, Lee WR. Are you the author?
Department of Radiation Oncology, Duke Cancer Institute, Durham, NC.
Reference: Semin Radiat Oncol. 2013 Jul;23(3):191-7.
doi: 10.1016/j.semradonc.2013.01.005
PubMed Abstract
PMID: 23763885
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