Ultra-hypofractionated radiotherapy leads to similar patient-reported quality of life outcomes versus conventionally fractionated radiotherapy for prostate cancer

This study compared the patient-reported quality of life outcomes between conventionally fractionated radiation treatment (CFRT) and ultra-hypofractionated radiation treatment (UHFRT) in patients with localized prostate cancer. The data showed that both radiotherapy techniques led to similar long-term outcomes.

Radiation therapy (RT) is a treatment used for localized prostate cancer. This can include conventional and ultra-hypofractionated treatments.

Conventionally fractionated radiation treatment (CFRT) involves using small doses of radiation 5 times a week for 6-8 weeks in order to shrink and kill the tumor cells. This allows normal cells to repair between treatments. Ultra-hypofractionated radiation treatment (UHFRT) involves a shorter course of treatment (2-3 weeks) with larger doses of radiation delivered in each treatment.

Previous studies showed that UHFRT was as safe and effective as CFRT in the treatment of PCa. However, whether UHFRT leads to similar patient-reported quality of life (QOL) outcomes compared to CFRT remains unclear.

This study involved 1165 patients with intermediate-to-high-risk PCa. They were randomly assigned to receive either CFRT (582) or UHFRT (583). The average follow-up period was 48 months. 71% of patients in the CFRT group and 66% of patients in the UHFRT group completed QOL questionnaires at 6 years.

Immediately after treatment, more patients in the UHFRT group reported bowel symptoms such as bloating, stool frequency and urgency, mucus, and blood in the stool. There was no difference in urinary or sexual symptoms between groups at the end of RT.

At the 6-year follow-up, 33% of CFRT had urinary and bowel problems compared with 28% of UHFRT patients. After 6 years, there were no statistical and clinically relevant differences in sexual functioning (60% vs 50%) and global health (42% vs 37%) outcomes between the CFRT and UHFRT groups.

This study showed that although immediately after treatment UHFRT led to more bowel problems, in the long-term it had similar patient-reported quality of life outcomes compared to CFRT in patients with PCa.

The patients included were from Sweden and Denmark. The questionnaire used is not applicable outside these countries.