Slightly higher dose radiation therapy over fewer weeks just as effective as standard regimen for early stage prostate cancer

Prostate cancer patients who received shorter, higher-dose course radiation treatment (MHFRT) had the same cancer control rates as those who received conventional radiotherapy. – Photo credit National Cancer Institute

CANCER DIGEST – March 22, 2025 – Delivering slightly higher doses of radiation per session over four to five weeks has been shown to be as effective a treatment for early stage prostate cancer as the conventional seven to eight weeks lower-dose course, a new UCLA study shows.

The large-scale study led by UCLA Health Jonsson Comprehensive Cancer Center researchers involved analysis of data from 5,800 patients in seven randomized clinical trials comparing standard dose radiation therapy and two different approaches using higher dose radiation over shorter periods, known as isodose moderately hypofractionated radiotherapy (MHFRT). 

The data analysis showed that the four-five week MHFRT regimen was just as effective in terms of five-year cancer progression, while the risk of long-term side effects to the bladder and intestines, such as urinary incontinence, chronic diarrhea, was no higher. Patients receiving the higher dose MHFRT, however, did report higher rates of bowel side effects. The results confirming earlier studies were published in the March 17, 2025 journal Lancet Oncology.

Nearly 83 percent of patients in both groups achieved the same five-year progression-free survival. Of the patients in the high-dose regimen, 7.2 percent reported higher gastrointestinal side effects, particularly bowel issues, compared to 4.9 percent in the standard regimen group.

“We believe these data strongly support that isodose MHFRT should become the preferred standard of care MHFRT regimen for prostate cancer,” said Dr. Amar Kishan, executive vice chair of radiation oncology at the David Geffen School of Medicine at UCLA and co-first author of the study. “More broadly, there appears to be little reason to consider conventional radiotherapy over MHFRT for the types of patients enrolled in these trials given these results.”

The study was funded in part by grants from the Department of Defense and the National Institutes of Health.

Sources: UCLA Health press release and Lancet Oncology