Hypofractionated Radiation Therapy for Localized Prostate Cancer: An ASTRO Clinical Practice Guideline.
Hypofractionated radiation therapy is recommended for localized prostate cancer.
Hypofractionated Radiation Therapy for Localized Prostate Cancer: An ASTRO Clinical Practice Guideline.
This guideline provides evidence-based recommendations on the use of hypofractionated external beam radiation therapy (external beam radiation therapy) in patients with localized prostate cancer, including indications for moderate hypofractionation (moderate hypofractionation) and ultrahypofractionation (ultrahypofractionation), appropriate dose-fractionation regimens, target volumes, and treatment planning and delivery techniques.
The American Society for Radiation Oncology convened a multidisciplinary task force to address 5 key questions related to hypofractionated external beam radiation therapy in localized prostate cancer.
Moderate hypofractionation is recommended over conventional fractionation for patients receiving external beam radiation therapy across all risk groups, supported by high-quality randomized data demonstrating equivalent oncologic outcomes, toxicity, and quality of life, with shorter treatment duration that may reduce overall treatment burden.
Ultrahypofractionation is recommended as a standard treatment option for patients with low- and intermediate-risk disease electing for definitive external beam radiation therapy and may be considered in selected patients with high-risk disease, preferably in the context of clinical trials.
Hypofractionated external beam radiation therapy has become the predominant form of definitive radiation therapy for localized prostate cancer, supported by mature randomized evidence demonstrating comparable outcomes to conventional fractionation and reduced treatment burden.
Ongoing studies will further refine patient selection, the role of ultrahypofractionation in higher-risk disease, and integration of advanced imaging and adaptive technologies.