Clinical Outcomes of Hypofractionated Radiotherapy With 12 Fraction for Low‐ and Intermediate‐Risk Localized Prostate Cancer

OBJECTIVES: Hypofractionated radiotherapy for prostate cancer has recently gained attention, with growing evidence supporting the clinical use of hypofractionation. This retrospective study aimed to compare the outcomes of hypofractionated radiotherapy with conventional fractionation. METHODS: Between 2012 and 2021, patients with low- or intermediate-risk prostate cancer treated at our institution were included. Patients were divided into two groups: the conventional group (78.0 Gy in 39 fractions over 8 weeks) and the hypofractionated group (51.6 Gy in 12 fractions over 2.5 weeks). Survival outcomes and toxicities were compared between the two groups. RESULTS: A total of 96 patients were included: 54 in the conventional group and 42 in the hypofractionated group. The median follow-up time was 110.5 months (IQR: 78.3-125.0) in the conventional group and 73.5 months (IQR: 57.8-83.5) in the hypofractionated group. Only one patient in the conventional group experienced biochemical recurrence. There were no significant differences in acute grade ≥ 2 urinary or bowel toxicity between the two groups. Grade ≥ 2 late urinary toxicity was more frequent in the hypofractionated group (16.7% vs. 7.4%, p = 0.16), while grade ≥ 2 late bowel toxicity was more frequent in the conventional group (16.7% vs. 4.8%, p = 0.07). CONCLUSIONS: Hypofractionated radiotherapy demonstrated comparable oncological outcomes and an acceptable toxicity profile to those of conventionally fractionated radiotherapy in patients with low- to intermediate-risk prostate cancer.