A phase III clinical trial demonstrated that an ultra-hypofractionated radiotherapy regimen delivered over 2.5 weeks may be as safe and effective as the conventional 8-week course for treating localized prostate cancer, with comparable outcomes sustained through 10 years of follow-up.

In the HYPO-RT-PC trial, which enrolled 1,200 men with intermediate- to high-risk localized prostate cancer, researchers found that the shortened treatment schedule delivered equivalent long-term cancer control and survival rates while maintaining a similar adverse effect profile to the standard approach.

"These findings confirm that the shorter course does not increase long-term side effects and provides equally durable cancer control," said study author Camilla Thellenberg-Karlsson, MD, PhD, of Umeå University, who presented the results at ESTRO 2025.

The findings validate previous 5-year results and provide evidence supporting broader adoption of this more efficient treatment protocol.

Key Trial Design and Outcomes

The researchers randomly assigned patients to receive either short-course radiotherapy (42.7 Gy delivered in 7 fractions over 2.5 weeks) or standard-course radiotherapy (78.0 Gy delivered in 39 fractions over 8 weeks). They then assessed survival, cancer recurrence, and treatment-related adverse effects, including urinary and bowel symptoms.

After 10 years of follow-up:

• Failure-free survival: 72% (short-course) vs 65% (standard-course)

• Overall survival: 81% (short-course) vs 79% (standard-course)

• Prostate cancer–specific mortality: 4% in both groups

• Adverse effects: Urinary and bowel symptoms were similar in both groups, with most being mild to moderate.

Clinical Significance

"Shorter treatment schedules mean patients can return to their normal lives more quickly. Reducing treatment time to just 2.5 weeks is a major win for both patients and health systems," said study authors Per Nilsson and Adalsteinn Gunnlaugsson, Associate Professors who led the 10-year outcome analysis at Skåne University Hospital and Lund University in Sweden.

Source: ESTRO 2025