title: Hypofractionation for clinically localized prostate cancer.
abstract: This manuscript reviews the clinical evidence for hypofractionation in prostate cancer, focusing on data from prospective trials. For the purposes of this manuscript, we categorize hypofractionation as moderate (2.4-4 Gy per fraction) or extreme (6.5-10 Gy per fraction). Five randomized controlled trials have evaluated moderate hypofractionation in >1500 men, with most followed for >4-5 years. The results of these randomized trials are inconsistent. No randomized trials or other rigorous comparisons of extreme hypofractionation with conventional fractionation have been reported. Prospective single-arm studies of extreme hypofractionation appear favorable, but small sample sizes preclude precise estimates of efficacy and short follow-up prevents complication estimates beyond 3-5 years. Over the next several years, the results of 3 large noninferiority trials of moderate hypofractionation and 2 randomized trials of extreme hypofractionation should help clarify the role of hypofractionation in prostate cancer therapy.
authors.affiliation: Department of Radiation Oncology, Duke Cancer Institute, Durham, NC 27710, USA. alvin.cabrera@duke.edu
authors.forename: Alvin R
authors.initials: AR
authors.lastname: Cabrera
authors.forename: W Robert
authors.initials: WR
authors.lastname: Lee
mesh_terms: D019583:Dose Fractionation, Radiation; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome