Hypofractionated radiotherapy for prostate cancer (HYDRA): An individual patient data meta-analysis of randomized trials in the MARCAP consortium.

• DOI: 10.1200/jco.2025.43.5_suppl.385
• Publication Date: 2025-02-18T14:35:11Z
• Authors: Amar Upadhyaya Ki...; Yilun Sun; David P. Dearnaley; Emma Hall; Alison Tree; Charles Catton; Himanshu Lukka; William Robert Lee; Howard M. Sandler; Luca Incrocci; Wilma Heemsbergen; Jessica Karen Wong; Eric M. Horwitz; Karen E. Hoffman; Comron Hassanzadeh; Deborah A. Kuban; Giuseppe Sanguineti; Stefano Arcangeli; John Nikitas; Daniel Eidelberg ...
• Keywords: Lernaean Hydra

385 Background: Trials comparing moderately hypofractionated radiotherapy (MHFRT) against conventionally-fractionated (CFRT) for prostate cancer have varied considerably in intent (non-inferiority vs. superiority) and MHFRT dose. Herein, we compare the efficacy toxicity profiles of isodose dose-escalated MHFRT. Methods: Individual patient data were obtained from 7 phase III trials CFRT: three (n=3454) with four (n=2426) Meta-analyses designed to progression-free survival (PFS), late grade ≥2 genitourinary (GU) gastrointestinal (GI) physician-scored toxicity, clinically-significant decrements patient-reported urinary or bowel quality life (QOL). Results: After a median follow-up 5.4 years (interquartile range [IQR], 4.6-7.2) 7.1 (IQR 5.7-8.4) following MHFRT, there no differences PFS (hazard ratio [HR] 0.92, 95%CI 0.81-1.05 HR 0.94, 0.82-1.09, respectively). Neither nor associated increased odds GU (odds [OR] 1.16 95CI% 0.86-1.57 OR 1.20, 0.95-1.51). The GI higher (OR 1.48, 1.14-1.92) but not 1.30, 95% 0.59-2.87). Isodose did show different 1.03, 0.51-2.09) 0.76, 0.40-1.43) QOL decrements, while was greater 1.68, 1.07-2.61), 1.57, 0.87-2.85), decrement. Conclusions: both similar compared CFRT, is toxicity. regimens, e.g. 60 Gy 20 fractions, should be standard regimen localized cancer.