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01-02-2021 | Prostate Cancer | Review Article

Ultrahypofractionation of localized prostate cancer

Statement from the DEGRO working group prostate cancer

Authors: Frank Wolf, Felix Sedlmayer, Daniel Aebersold, Clemens Albrecht, Dirk Böhmer, Michael Flentje, Ute Ganswindt, Pirus Ghadjar, Stefan Höcht, Tobias Hölscher, Arndt-Christian Müller, Peter Niehoff, Michael Pinkawa, Nina-Sophie Schmidt-Hegemann, Constantinos Zamboglou, Daniel Zips, Thomas Wiegel

Published in: Strahlentherapie und Onkologie | Issue 2/2021

Abstract

Due to its low fractionation sensitivity, also known as “alpha/beta ratio,” in relation to its surrounding organs at risk, prostate cancer is predestined for hypofractionated radiation schedules assuming an increased therapeutic ratio compared to normofractionated regimens. While moderate hypofractionation (2.2–4 Gy) has been proven to be non-inferior to normal fractionation in several large randomized trials for localized prostate cancer, level I evidence for ultrahypofractionation (>4 Gy) was lacking until recently. An accumulating body of non-randomized evidence has recently been strengthened by the publication of two randomized studies comparing ultrahypofractionation with a normofractionated schedule, i.e., the Scandinavian HYPO-RT trial by Widmark et al. and the first toxicity results of the PACE‑B trial. In this review, we aim to give a brief overview of the current evidence of ultrahypofractionation, make an overall assessment of the level of evidence, and provide recommendations and requirements that should be followed before introducing ultrahypofractionation into routine clinical use.

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Title: Ultrahypofractionation of localized prostate cancer
Statement from the DEGRO working group prostate cancer
Authors: Frank Wolf
Felix Sedlmayer
Daniel Aebersold
Clemens Albrecht
Dirk Böhmer
Michael Flentje
Ute Ganswindt
Pirus Ghadjar
Stefan Höcht
Tobias Hölscher
Arndt-Christian Müller
Peter Niehoff
Michael Pinkawa
Nina-Sophie Schmidt-Hegemann
Constantinos Zamboglou
Daniel Zips
Thomas Wiegel
Publication date: 01-02-2021
Publisher: Springer Berlin Heidelberg
Keywords: Prostate Cancer
Prostate Cancer
Radiotherapy
Published in: Strahlentherapie und Onkologie / Issue 2/2021
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-020-01723-8

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Ultrahypofractionation of localized prostate cancer

Statement from the DEGRO working group prostate cancer

Abstract

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Abstract

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