Hypofractionated Radiation Therapy Offers Value-Based Care for Patients With Prostate Cancer

In the first study to evaluate patient-reported outcomes from the NRG Oncology/RTOG 0415 trial, treatment with hypofractionated radiation therapy offers similar health-related quality of life (HRQoL) outcomes in one-third less treatment time compared with conventional radiation therapy in men with early stage, low-risk prostate cancer, reported researchers at the 58th Annual Meeting of the American Society for Radiation Oncology.
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“This research shows that hypofractionated radiation therapy offers patients value-based care for their disease. If patients with low-risk prostate cancer choose radiation therapy, they can live equally long and have the same quality of life outcomes with 28 daily treatments, compared to what has been the standard care of 41 daily treatments,” said lead study author Deborah Watkins Bruner, PhD, a professor at the Nell Hodgson Woodruff School of Nursing and a professor of radiation oncology at Emory University School of Medicine in Atlanta.

The trial assessed the differences in HRQoL using the Expanded Prostate Index Composite (EPIC) questionnaire, which measured side effects in each of EPIC’s four domains: bowel, urinary, sexual, and hormonal side effects. Patients were randomly assigned to receive conventional radiation therapy, consisting of 73.8 Gy in 41 daily treatments for 8.2 weeks, or hypofractionated radiation therapy, consisting of 70 Gy in 28 daily treatments for 5.6 weeks. A total of 962 patients reported HRQoL data, which was collected at baseline, six months after treatment began, and 1-year post-treatment.

Following treatment, patients who received higher doses of hypofractionated radiation therapy in fewer sessions reported comparable HRQoL as the patients who received conventional radiation therapy. No differences in change scores for either group on any EPIC domain at six months’ follow-up was observed. At 12 months, the hypofractionated radiation therapy group reported a larger decline in the bowel domain compared with those who received conventional radiation therapy, with an average from baseline of -3.6 vs -1.8, respectively (P=.0037), but the change was not deemed clinically significant to patients.