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Moderate hypofractionation for prostate cancer: A user's guide
Author(s) -
Pryor David I,
Turner Sandra L,
Tai Keen Hun,
Tang Colin,
Sasso Giuseppe,
Dreosti Marcus,
Woo Henry H,
Wilton Lee,
Martin Jarad M
Publication year - 2018
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12703
Subject(s) - medicine , prostate cancer , androgen deprivation therapy , dose fractionation , radiation therapy , toxicity , clinical trial , cancer , prostate , oncology
Summary Three large randomised controlled trials have been published in the last year demonstrating the non‐inferiority of moderate hypofractionation compared to conventional fractionation for localised prostate cancer with respect to both disease control and late toxicity at 5 years. Furthermore, no clinically significant differences in patient‐reported outcomes have emerged. More mature follow‐up data are now also available from phase 2 studies confirming that moderate hypofractionation is associated with low rates of significant toxicity at 10 years. Moving forward it is likely that appropriate patient selection, integration of androgen deprivation and attention to optimising technique will play a more important role than modest differences in dose‐fractionation schedules. Here we briefly review the evidence, discuss issues of patient selection and provide an approach to implementing moderately hypofractionated radiation therapy for prostate cancer in clinical practice.