Prostate Cancer Treatment (PDQ®)–Health Professional Version

SECTIONS

Changes to This Summary (07/05/2016)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Treatment Option Overview for Prostate Cancer

Revised text to state that on the basis of limited data from randomized trials, the more convenient schedules of hypofractionated radiation therapy appear to yield similar outcomes to conventional radiation therapy schedules, at least with respect to the intermediate outcome of disease-free survival (DFS)—a low level of evidence not known to translate into health outcomes—but potentially offering more convenient schedules of treatment (added level of evidence 1iiDiii). Added that hypofractionated radiation may incur more toxicity than standard doses, depending on the schedules used.

Added text to state that in another multicenter, randomized trial of Hypofractionated versus Conventionally Fractionated Radiotherapy for Patients with Prostate Cancer, conventional radiation therapy doses were compared with hypofractionated radiation therapy doses in a noninferiority design for hypofractionation in 820 men with intermediate- or high-risk prostate cancer (cited Aluwini et al. as reference 64). The primary efficacy endpoints are pending. Also added that with respect to toxicity, noninferiority for hypofractionated radiation therapy could not be established after a median follow-up of 5 years: cumulative genitourinary (GU) toxicity of 41.3% with hypofractionated radiation therapy versus 39% with conventional radiation therapy; gastrointestinal (GI) toxicity of 21.9% versus 17.7%; cumulative grade 3+ GU toxicity was higher in the hypofractionation group, 19.0% versus 12.9%; stool frequency was higher in the hypofractionation group, 7% versus 3%.

Added text to state that the Radiation Therapy Oncology Group reported a noninferiority trial of 1,115 men with low-risk prostate cancer who were randomly assigned to receive hypofractionated radiation therapy versus conventional radiation therapy. Also added that after a median follow-up of 5.8 years, the hypofractionated radiation therap arm met the prospective noninferiority criterion with respect to DFS: 86.3% with hypofractionated radiation therapy versus 85.3% with conventional radiation therapy (cited Lee et al. as reference 65 and level of evidence 1iiDiii); there were 49 deaths in the hypofractionated radiation therapy arm and 51 deaths in the conventional radiation therapy arm; however, late GI grade 2+ toxicity was worse in the hypofractionated radiation therapy arm: 22.4% versus 14.0%; there was also a trend toward worse late GU grade 2+ toxicity: 29.7% versus 22.8%.

Recurrent Prostate Cancer Treatment

Added Sternberg et al. as reference 27.

Added Cella et al. as reference 28.

This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.

< Previous section
Key References for Prostate Cancer

Next section >
About This PDQ Summary