Ultra-Hypofractionated Radiotherapy Noninferior for Prostate Cancer
THURSDAY, May 8, 2025 -- Ultra-hypofractionated (UHF) radiotherapy delivered over two weeks is noninferior to conventionally fractionated (CF) radiotherapy delivered over eight weeks for localized prostate cancer up to 10 years, according to a study presented at the annual meeting of the European Society for Radiotherapy and Oncology, held from May 2 to 6 in Vienna.
Per Nilsson, Ph.D., from Skåne University Hospital in Lund, Sweden, and colleagues presented the 10-year efficacy and toxicity outcomes for UHF versus CF radiotherapy for men with intermediate- to high-risk localized prostate cancer. The per-protocol population included 1,180 men who were randomly assigned to UHF (42.7 Gy in seven fractions over 2.5 weeks) or CF radiotherapy (78.0 Gy in 39 fractions over eight weeks).
The researchers found that 178 and 205 primary outcome events (failure-free survival [FFS]) occurred in the UHF and CF groups, respectively, at a median follow-up of 10.6 years. For FFS, the adjusted hazard ratio was 0.84 (95 percent confidence interval, 0.69 to 1.03), confirming noninferiority. Up to approximately six years, the Kaplan-Meier curves were similar, after which they diverged, favoring UHF. At 10 years, the difference was significant. The two groups had similar overall survival, which was 81 and 79 percent in the UHF and CF groups, respectively, at 10 years. The cumulative incidence of prostate cancer-specific death was identical, at 4 percent at 10 years. Freedom from androgen-deprivation therapy did not differ significantly between the groups and was 77 and 75 percent in the UHF and CF groups, respectively, at 10 years. There were no statistically significant differences in late genitourinary and gastrointestinal toxicity between the groups.
"Delivering fewer, higher doses over a shorter period works just as well as the standard approach -- not just in theory, but in real-world clinical practice," Nilsson said in a statement.
Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.
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