Shorter radiotherapy course proves safe for prostate cancer

A major phase III clinical trial, led by Swedish researchers, has shown that a significantly shorter course of radiotherapy for localised prostate cancer is just as safe and effective as the traditional eight-week schedule — even 10 years after treatment. The trial’s findings, presented at ESTRO 2025, give both patients and doctors greater confidence in choosing this short-course approach, dubbed ‘ultra hypo-fractionated radiotherapy’.

Prostate cancer is understood to be the most commonly diagnosed cancer in men worldwide, accounting for more than 1.4 million new cases each year. For many patients, radiotherapy is a standard treatment option that offers outcomes comparable to surgery, particularly for localised disease, while allowing men to maintain much of their daily routine during treatment. However, traditional radiotherapy schedules typically span several weeks, which can be burdensome for patients and put pressure on healthcare structures and radiotherapy capacity.

Seeking to address this, the HYPO-RT-PC clinical trial enrolled 1200 men with intermediate- to high-risk localised prostate cancer. Participants were randomly assigned to receive either short-course radiotherapy — 42.7 Gray (Gy) delivered in seven sessions over 2.5 weeks — or standard-course radiotherapy (78 Gy delivered in 39 sessions over eight weeks). The researchers assessed survival, cancer recurrence and treatment-related side effects, including urinary and bowel symptoms.

The researchers found that delivering precision radiotherapy over 2.5 weeks is equally successful in beating prostate cancer as the standard eight-week approach, with both options producing similar disease control rates and survival a decade after treatment. Failure-free survival (no return of cancer or need for additional treatment) was 72% in the short-course group vs 65% in the standard group; overall survival was 81% for short-course vs 79% for standard; prostate cancer-specific mortality was 4% in both groups; and urinary and bowel symptoms were similar in both groups (mostly mild to moderate).

“These long-term findings confirm previous five-year results from the trial, showing that delivering fewer, higher doses over a shorter period works just as well as the standard approach — not just in theory, but in real-world clinical practice,” concluded Associate Professors Per Nilsson and Adalsteinn Gunnlaugsson, who led the 10-year outcome analysis of the HYPO-RT-PC trial at Skåne University Hospital and Lund University.

“For patients, this means less disruption to daily life and potentially lower healthcare costs — without compromising outcomes and safety.”

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