CHHiP (Conventional or Hypofractionated High Dose IMRT for Prostate Cancer)
CHHiP is a randomised phase 3, non-inferiority trial recruiting men with localised prostate cancer (pT1b-T3aN0M0). Patients were randomly assigned (1:1:1) to conventional (74 Gray (Gy) delivered in 37 fractions (f) over 7.4 weeks) or one of two hypofractionated schedules (60Gy/20f over 4 weeks or 57Gy/19f over 3.8 weeks) all delivered with intensity modulated techniques. The primary endpoint was time to biochemical/clinical failure; critical hazard ratio (HR) for non-inferiority was 1.208. The CHHiP trial is registered (ISRCTN97182923). From Oct 18, 2002 to June 17, 2011, 3216 men were recruited from 71 centres (74Gy: 1065, 60Gy: 1074, 57Gy: 1077). Median follow-up is 62.4 months (IQR 53.9-77.0). The proportion of patients biochemical/clinical failure-free at 5 years was 74Gy: 88.3% (95%CI 86.0-90.2), 60Gy: 90.6% (88.5-92.3), 57Gy: 85.9% (83.4-88.0). 60Gy was shown to be non-inferior to 74Gy: HR 0.84 (90%CI: 0.68-1.03) but non-inferiority could not be claimed for 57Gy: HR 1.20 (0.99-1.46). The α/β ratio for prostate cancer was estimated at 1.8Gy. There were similar long-term side-effects in all treatment groups with no significant difference in the proportion of patients reporting a RTOG grade 2 or worse bowel/bladder toxicity at 5 years (74Gy: 1.3%/1.7%, 60Gy: 2.3%/1.8%, p=0.26/p=1.00, 57Gy: 2.0%/1.8%, p=0.48/p=1.00). Hypofractionated radiotherapy using 60Gy/20f is non-inferior to conventional fractionation using 74Gy/37f and is recommended as a new standard of care.
- Malignant tumor of prostate (disorder)
Bespoke collection capabilities:
- Carcinoma in situ of prostate
The Institute of Cancer Research
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