ASCO-GU 2020 — Localized prostate cancer: long-term data support hypofractionated radiotherapy


  • Deepa Koli
  • Univadis
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Takeaway

  • 8-year follow up of CHHiP trial confirms noninferiority of the 60-Gy regimen of hypofractionated radiotherapy vs conventional dose in patients with node-negative localized prostate cancer (PCa).

Why this matters

  • Findings support the continued use of 60Gy/20f as standard of care for men with localized PCa.

Study design

  • CHHiP trial: 3216 men with node-negative T1b-T3a prostate cancer were randomly assigned 1:1:1 to conventional regimen (74 Gy/37 fractions), a hypofractionated regimen of 60 Gy in 20 fractions, or a hypofractionated regimen of 57 Gy in 19 fractions.
  • Non-inferiority criteria: upper bound of the confidence interval
  • Funding: Cancer Research UK; others.

Key results

  • Median follow up, 9.2 years.
  • 8-year biochemical or clinical failure-free rates:
    • 74Gy: 80.6%;
    • 60Gy: 83.7%; 
    • 57Gy: 78.5%.
  • 60Gy regimen was non-inferior to conventional 74 Gy regimen (HR, 0.84; 90% CI, 0.71-0.99).
  • Non-inferiority could not be confirmed for 57Gy dose (HR, 1.17; 90% CI 1.00, 1.37). 
  • 5-year toxicity rates in the 74Gy, 60Gy and 57Gy groups,
    • Bowel: 1.6%, 2.0%, and 1.9%, respectively; and
    • Bladder: 1.9%, 1.5%, 1.9%, respectively.

Expert commentary

Dr. Paul L Nguyen, MD, Dana-Farber Cancer Institute, Boston said: “It is very reassuring that the initial results the investigators presented several years ago still hold up in the long term — it’s great to know that we can use it across the age spectrum and it works well.”