High quality.

The phase 2 RTOG 0938 prospectively assessed almost 250 men with low risk prostate cancer treated with one of two extreme hypofractionated radiation regimens: [1] 36.25 Gy in 5 fractions delivered every other day or [2] 51.6 Gy in 12 fractions delivered daily. Max hot spot within the target was limited to ≤107%, with the exception of CyberKnife planning where ≤120% was allowed as long as the urethra was still kept ≤107%. Side note: Such requirements for dose homogeneity is why even 5-fraction radiation of the prostate is not technically considered stereotactic body radiation (SBRT). The goal of this study was to supplement ensuing phase 3 trials assessing disease outcomes. As such, the primary endpoint here was quality of life as measured by the rates of decreases of at least half a standard deviation in EPIC bowel and bladder scores at one year, which were 29% and 44%, respectively, compared to 35% and 39% in the RTOG 0415 trial of standard fractionation. TBL: Prospective data shows quality of life from bowel and bladder function following extreme hypofractionation compares well to that with standard fractionation in the definitive treatment of low-risk prostate cancer. | Lukka, Int J Radiat Oncol Biol Phys 2018