title: Hypofractionated radiotherapy for localized prostate cancer.
abstract: OBJECTIVE
  This article gives an overview on the current status of hypofractionated radiotherapy in the treatment of prostate cancer with a special focus on the applicability in routine use.
  
  
  METHODS
  Based on a recently published systematic review the German Society of Radiation Oncology (DEGRO) expert panel added additional information that has become available since then and assessed the validity of the information on outcome parameters especially with respect to long-term toxicity and long-term disease control.
  
  
  RESULTS
  Several large-scale trials on moderate hypofractionation with single doses from 2.4-3.4 Gy have recently finished recruiting or have published first results suggestive of equivalent outcomes although there might be a trend for increased short-term and possibly even long-term toxicity. Large phase 3 trials on extreme hypofractionation with single doses above 4.0 Gy are lacking and only very few prospective trials have follow-up periods covering more than just 2-3 years.
  
  
  CONCLUSIONS
  Until the results on long-term follow-up of several well-designed phase 3 trials become available, moderate hypofractionation should not be used in routine practice without special precautions and without adherence to the highest quality standards and evidence-based dose fractionation regimens. Extreme hypofractionation should be restricted to prospective clinical trials.
authors.affiliation: Radiologie, Nuklearmedizin und Strahlentherapie, Xcare Gruppe, Saarlouis, Germany. stefan.hoecht@googlemail.com.
authors.forename: Stefan
authors.initials: S
authors.lastname: Höcht
authors.affiliation: Universitätsklinik für Radio-Onkologie, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Aebersold
authors.affiliation: Klinik für Radioonkologie und Gemeinschaftspraxis für Strahlentherapie, Klinikum Nürnberg Nord, Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Nuremberg, Germany.
authors.forename: Clemens
authors.initials: C
authors.lastname: Albrecht
authors.affiliation: Klinik für Radioonkologie und Strahlentherapie, Charité Universitätsmedizin, Berlin, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Böhmer
authors.affiliation: Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Würzburg, Würzburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Flentje
authors.affiliation: Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Ute
authors.initials: U
authors.lastname: Ganswindt
authors.affiliation: Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Hölscher
authors.affiliation: Klinik für Strahlentherapie und Radioonkologie, Klinikum Bremen-Mitte, Bremen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Martin
authors.affiliation: Universitätsklinik für Radiotherapie und Radio-Onkologie, Landeskrankenhaus, Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Salzburg, Austria.
authors.forename: Felix
authors.initials: F
authors.lastname: Sedlmayer
authors.affiliation: Klinik für Strahlentherapie und Radioonkologie, Universitätsmedizin Mannheim, Universität Heidelberg, Mannheim, Germany.
authors.forename: Frederik
authors.initials: F
authors.lastname: Wenz
authors.affiliation: Universitätsklinik für Radioonkologie, Universitätsklinikum Tübingen, Tübingen, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Zips
authors.affiliation: Abteilung Strahlentherapie, Universitätsklinikum Ulm, Ulm, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wiegel
mesh_terms: D004307:Dose-Response Relationship, Radiation; D019317:Evidence-Based Medicine; D005858:Germany; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000532:radiotherapy*; D000069473:Radiation Dose Hypofractionation; D011832:Radiation Injuries / Q000209:etiology* / Q000517:prevention & control; D020266:Radiotherapy, Conformal / Q000009:adverse effects* / Q000379:methods*; D018570:Risk Assessment; D016896:Treatment Outcome
keywords: Hypofractionation; Prostate cancer; Radiotherapy