The short of it.

Top Line: Every few weeks rad oncs like to revisit hypofraction for prostate cancer.

The Study: If you think it’s pretty well established by now, you’re not wrong. Today we bring you an iteration comparing patient-reported outcomes with conventionally fractionated versus hypofractionated definitive radiation to the prostate and pelvic lymph nodes for high risk prostate cancer. Patient-reported outcomes were prospectively captured from 96 men randomized on a phase II trial to either conventionally fractionated pelvic and prostate RT (78 Gy in 39 fractions with a sequential boost technique) or hypofractionated pelvic and prostate radiation (68 Gy in 25 fractions with a simultaneous integrated boost technique). A big practical plus to this manuscript is that the primary dose constraints for each arm are included in the methods. While EPIC GI scores trended worse in the short term after hypofractionation, short term physical health-related quality of life trended worse with conventional fractionation. At 24 months post-treatment, there were no differences in any of the five measured outcomes.

TBL: Growing amounts of data continue to indicate little downside to hypofractionation for the prostate, even when including simultaneous elective pelvic lymph node radiation. | Yang, Int J Radiat Oncol Biol Phys 2022