Review Article

Prostate Radiotherapy in the Era of Advanced Imaging and Precision Medicine

Table 2

Randomized controlled trials evaluating the efficacy and toxicity of hypofractionated radiation regimens.

Trial, inclusion criteriaDose (dose per fraction)Outcome

Early hypofractionation trials Lukka et al. [44]936
GS 6–10
52.5 Gy (2.625 Gy)
66 Gy (2 Gy)
40% versus 43% 5-year freedom from biochemical failure
Yeoh et al. [45]21755 Gy (2.75 Gy)
64 Gy (2 Gy)
53% versus 34% 7-year freedom from biochemical failure

Modern superiority trials Hoffman et al. [47]204
99% low-intermediate risk
72 Gy (2.4 Gy)
75.6 Gy (1.8 Gy)
96% versus 92% 5-year freedom from biochemical failure
Pollack et al. [49]303
GS 6+
70.2 Gy (2.7 Gy)
78 Gy (2.17 Gy)
23% versus 21% 5-year biochemical or clinical disease failure
Arcangeli et al. [48]168
GS 7+
62 Gy (3.1 Gy)
80 Gy (2 Gy)
85% versus 79% 5-year freedom from biochemical failure

Modern noninferiority trials Dearnaley et al. [46]45757 Gy (3 Gy)
60 Gy (3 Gy)
74 Gy (2 Gy)
Similar GU and GI toxicity ≥ grade 2 (<5%)
Incrocci [52]820
Intermediate-high risk
64.6 Gy (3.4 Gy)
78 Gy (2 Gy)
Worse GI toxicity ≥ grade 2, similar GU toxicity
RTOG 0415 [51]1101
Low risk
70 Gy (2.5 Gy)
73.8 Gy (1.8 Gy)
Noninferior biochemical recurrence and overall survival, similar toxicity
PROFIT [53]Intermediate risk60 Gy (3 Gy)
78 Gy (2 Gy)
Pending

GS: Gleason score. Gy: Gray.