Hypofractionated beam radiotherapy for localized prostate cancer

This article gives an overview on the current status of hypofractionated radiotherapy in the treatment of prostate cancer with a special focus on the applicability in routine use.

Based on a recently published systematic review the German Society of Radiation Oncology (DEGRO) expert panel added additional information that has become available since then and assessed the validity of the information on outcome parameters especially with respect to long-term toxicity and long-term disease control.

Several large-scale trials on moderate hypofractionation with single doses from 2.4-3.4 Gy have recently finished recruiting or have published first results suggestive of equivalent outcomes although there might be a trend for increased short-term and possibly even long-term toxicity. Large phase 3 trials on extreme hypofractionation with single doses above 4.0 Gy are lacking and only very few prospective trials have follow-up periods covering more than just 2-3 years.

Until the results on long-term follow-up of several well-designed phase 3 trials become available, moderate hypofractionation should not be used in routine practice without special precautions and without adherence to the highest quality standards and evidence-based dose fractionation regimens. Extreme hypofractionation should be restricted to prospective clinical trials.

Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]. 2016 Sep 14 [Epub ahead of print]

Stefan Höcht, Daniel M Aebersold, Clemens Albrecht, Dirk Böhmer, Michael Flentje, Ute Ganswindt, Tobias Hölscher, Thomas Martin, Felix Sedlmayer, Frederik Wenz, Daniel Zips, Thomas Wiegel

Radiologie, Nuklearmedizin und Strahlentherapie, Xcare Gruppe, Saarlouis, Germany. ., Universitätsklinik für Radio-Onkologie, Inselspital, University of Bern, Bern, Switzerland., Klinik für Radioonkologie und Gemeinschaftspraxis für Strahlentherapie, Klinikum Nürnberg Nord, Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Nuremberg, Germany., Klinik für Radioonkologie und Strahlentherapie, Charité Universitätsmedizin, Berlin, Germany., Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Würzburg, Würzburg, Germany., Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Ludwig-Maximilians-Universität München, Munich, Germany., Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany., Klinik für Strahlentherapie und Radioonkologie, Klinikum Bremen-Mitte, Bremen, Germany., Universitätsklinik für Radiotherapie und Radio-Onkologie, Landeskrankenhaus, Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Salzburg, Austria., Klinik für Strahlentherapie und Radioonkologie, Universitätsmedizin Mannheim, Universität Heidelberg, Mannheim, Germany., Universitätsklinik für Radioonkologie, Universitätsklinikum Tübingen, Tübingen, Germany., Abteilung Strahlentherapie, Universitätsklinikum Ulm, Ulm, Germany.