Guidelines Updated for Short-Course Radiation for Localized Prostate Cancer

FRIDAY, Nov. 13, 2026 (HealthDay News) — For patients with localized prostate cancer receiving external beam radiation therapy (EBRT), moderate hypofractionation (MHF) is recommended over conventional fractionation across all risk groups and ultrahypofractionation (UHF) is recommended for those with low- and intermediate-risk disease, according to a clinical practice guideline issued by the American Society for Radiation Oncology and published online Oct. 27 in Practical Radiation Oncology.

Scott C. Morgan M.D., from the University of Ottawa in Ontario, Canada, and colleagues conducted a systematic literature review to address key questions related to hypofractionated EBRT in localized prostate cancer.

The authors note that for patients receiving EBRT, MHF is recommended over conventional fractionation across all risk groups, supported by high-quality randomized data showing equivalent oncologic outcomes, toxicity, and quality of life; overall treatment burden may be reduced by shorter treatment duration. For patients with low- and intermediate-risk disease electing for definitive EBRT, UHF is recommended as a standard treatment option and may be considered in selected patients with high-risk disease, ideally in the context of clinical trials. MHF may be preferred over UHF for patients with significant baseline urinary dysfunction, but selection of fractionation should generally be independent of patient age, comorbidity, and use of androgen deprivation therapy. To optimize target coverage and minimize toxicity, the use of contemporary image-guided, conformal treatment techniques is supported by evidence.

“This guideline also reflects how treatment planning has evolved, including greater use of daily image guidance and more precise approaches to managing motion during treatment,” guideline coauthor Karen Hoffman, M.D., M.P.H., from the University of Texas MD Anderson Cancer Center in Houston, said in a statement.

Several authors disclosed ties to the biopharmaceutical industry.

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