PCa: NRG trial supports hypofractionated RT as standard of care

  • Bruner DW & al.
  • JAMA Oncol
  • 14 Feb 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • In low-risk men with localized prostate cancer (PCa), treatment with hypofractionated radiotherapy (HRT) is not inferior to conventional radiotherapy (CRT) in terms of health-related QoL, anxiety, and depression.

Why this matters

  • QoL findings support HRT as a new standard of care for men who decide to undergo treatment.
  • Prior data supported noninferior disease-free survival.

Study design

  • Multinational, phase 3, noninferiority, NRG-RTOG 0415 trial.
  • 1092 low-risk men with localized PCa were randomly assigned to CRT (73.8 Gy in 41 fractions over the course of 8.2 weeks) or HRT (70 Gy in 28 fractions over the course of 5.6 weeks).
  • Funding: National Cancer Institute.

Key results

  • Expanded Prostate Cancer Index Composite (EPIC) questionnaire scores were not statistically different between treatment at 6, 24, or 60 months.
    • At 12 months, HRT showed a greater decline vs CRT group in the bowel domain (mean score, −7.5 vs −3.7; P<.001 but the difference was not clinically significant>
  • Hopkins Symptom Checklist-25 for anxiety and depression: no difference was observed in patients with caseness (score ≥44) between groups.
  • No difference was observed in EuroQol-5 Dimension questionnaire scores.

Limitations

  • Single time point for EPIC endpoint was not specified.

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