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Guideline on shorter-course radiation therapy for localized prostate cancer updated

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Guideline on shorter-course radiation therapy for localized prostate cancer updated

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An updated clinical guideline from the American Society for Radiation Oncology (ASTRO) provides evidence-based recommendations on the use of hypofractionated radiation therapy for patients with localized prostate cancer. The guideline replaces ASTRO's 2018 recommendations and reflects a matured evidence base showing that shorter-course radiation therapy can maintain cancer control while reducing overall treatment burden for patients receiving definitive external beam radiation therapy (EBRT). The guideline was published in Practical Radiation Oncology.

Approximately one in eight men will be diagnosed with prostate cancer during their lifetime. It is the second most common cancer among men in the United States, after skin cancer. In 2026, nearly 334,000 new cases of prostate cancer will be diagnosed among U.S. adults. When prostate cancer is diagnosed while still localized, outcomes are generally excellent, and patients often have several effective approaches to consider based on their individual priorities.

For patients with localized prostate cancer who choose radiation therapy, EBRT is a standard definitive treatment option. Hypofractionated EBRT delivers radiation therapy in fewer treatment sessions than conventional fractionation, using a higher dose per treatment while maintaining a similar overall therapeutic effect. Moderate hypofractionation typically is delivered over four to six weeks, while ultrahypofractionation, most commonly delivered as stereotactic body radiation therapy (SBRT), allows patients to complete treatment in five sessions over one to two weeks.

The updated guideline recommends moderate hypofractionation over conventional fractionation for patients across all prostate cancer risk groups who choose EBRT, supported by high-quality randomized data showing comparable outcomes, side effects and quality of life.


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