Patient-reported bowel symptoms were similar between patients with intermediate-risk localized prostate cancer who received hypofractionated radiotherapy compared with patients who received a standard fractionation schedule, according to a study published online ahead of print in The Lancet Oncology.1
Patient-reported outcomes (PROs) sometimes are more indicative of toxic effects of radiotherapy than clinician-reported outcomes.
Therefore, investigators conducted a substudy of the phase 3 CHHiP trial to assess PROs up to 24 months following conventionally fractionated or hypofractionated radiotherapy.
Patients included men with localized prostate cancer undergoing radiotherapy. Patients had histologially confirmed T1b-T3aN0M0 prostate cancer, prostate-specific antigen concentration less than 30 ng/mL, and a WHO performance score of 0 to 1.
A total of 2,100 patients were randomly assigned to receive standard fractionation at a schedule of 74 Gy in 37 fractions (n = 696) or one of either 60 Gy in 20 fractions (n = 698) or 57 Gy in 19 fractions (n = 706).
At 2 years, comparison among the 3 groups showed no difference in overall bother, with 66% of patients in the 74 Gy reporting none, 65% of patients in the 60 Gy reporting none, and 65% of patients in the 57 Gy group reporting none. Very small bother was reported in 22%, 22%, and 21% of patients, respectively.
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Small bother was reported in 6%, 7%, and 9% of men, respectively; moderate bother was reported in 5%, 6%, and 5% of patients; and severe bother was reported in < 1% of all participants in all groups (74 Gy vs 60 Gy, ptrend = .64, 74 Gy vs 57 Gy, ptrend = .59).
Results indicated that if efficacy data from the CHHip trial show non-inferiority for hypofractionated radiotherapy, it should become the standard treatment for localized prostate cancer.
- Wilkins A, Mossop H, Syndicus I, et al. Hypofractionated radiotherapy versus conventionally fractionated radiotherapy for patients with intermediate-risk localised prostate cancer: 2-year patient-reported outcomes of the randomised, non-inferiority, phase 3 CHHiP trial [published online ahead of print October 28, 2015]. Lancet Oncol. doi: 10.1016/ S1470-2045(15)00280-6.