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Hypofractionated Radiation Provides Same Prostate Outcomes as Conventional Radiation

An analysis led by researchers at Fox Chase Cancer Center found that treating localized prostate cancer with hypofractionated intensity modulated radiation therapy (H-IMRT) yields equivalent disease outcomes compared with conventional intensity modulated radiation (C-IMRT). It is the largest randomized single-institution study with the longest follow up period on this topic to date.

The study enrolled 300 men and followed them over a median period of 11 years after treatment. One-half had received H-IMRT and one-half had received C-IMRT. Men in both groups also received standard of care androgen deprivation therapy when it was indicated. H-IMRT delivers more radiation per treatment session, allowing patients to complete treatment over a much shorter period than C-IMRT (5.5 weeks vs eight weeks). Advantages include fewer medical appointments, lower costs, and more efficient utilization of clinical resources.

At five years and 10 years after treatment, men who had received either form of therapy showed similar results on several measures, including prostate-specific antigen control and overall survival. There was initially some pause for concern for a trend toward higher rate of developing metastases in the H-IMRT group, however this was not statistically significant and no subset of patients seemed to be at higher risk on further analysis.

Vladimir Avkshtol, MD, a radiation oncology resident at Fox Chase, presented the results at an oral session at the 60th Annual ASTRO Meeting in San Antonio on October 22. 

"Our analysis shows that for most men with localized prostate cancer, H-IMRT is a viable option and should be considered for most men. Our study is one of the biggest and most mature studies of its kind in the US.," Avkshtol said.