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Current Urology Reports

, 20:53 | Cite as

Hypofractionated Radiotherapy for Localized Prostate Cancer: When and for Whom?

  • Soumyajit Roy
  • Scott C. MorganEmail author
Prostate Cancer (S Prasad, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Prostate Cancer

Abstract

Purpose of Review

To summarize recent evidence concerning the use of moderately hypofractionated external beam radiotherapy, defined as 2.4–3.4 Gy per fraction, and ultrahypofractionated external beam radiotherapy (also known as stereotactic body radiotherapy [SBRT]), defined as at least 5 Gy per fraction, in men with localized prostate cancer.

Recent Findings

Taken together, a number of recently completed randomized trials show that moderately hypofractionated radiotherapy confers similar biochemical control compared to conventionally fractionated radiotherapy without increasing late toxicity. These effects appear to extend across all baseline clinical risk groups. Several single-arm phase II studies, as well as a recently published large-scale randomized trial comparing SBRT with conventional fractionation, show very promising biochemical control and favorable acute and late treatment-related morbidity with the use of SBRT in predominantly low- and intermediate-risk prostate cancer.

Summary

As it is associated with similar prostate cancer control and toxicity while improving patient convenience and reducing cost, moderate hypofractionation is a preferred alternative to conventional fractionation in a majority of men with localized prostate cancer choosing radiotherapy as their primary treatment modality. To date, studies conducted largely in low- and intermediate-risk prostate cancer report encouraging oncologic outcomes and acceptable toxicity with SBRT. Mature results of phase III trials evaluating five-fraction SBRT regimens are eagerly awaited.

Keywords

Prostate cancer Hypofractionated radiotherapy External beam radiotherapy 

Notes

Compliance with Ethical Standards

Conflict of Interest

Soumyajit Roy declares no potential conflicts of interest.

Scott C. Morgan is on the advisory board and consults for Astellas, Bayer Healthcare, and Janssen.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Radiation Oncology Branch, National Cancer Institute, National Institutes of HealthBethesdaUSA
  2. 2.Division of Radiation Oncology, The Ottawa Hospital Cancer CentreOttawaCanada
  3. 3.Division of Radiation OncologyUniversity of OttawaOttawaCanada

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