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HYPORT Noninferior for GU, GI Toxicity in Prostate Cancer

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24-month differences in genitourinary and gastrointestinal change scores were noninferior for HYPORT versus COPORT

By Elana Gotkine HealthDay Reporter

WEDNESDAY, April 10, 2024 (HealthDay News) — For patients with prostate cancer, hypofractionated postprostatectomy radiotherapy (HYPORT) is noninferior to conventionally fractionated postprostatectomy radiotherapy (COPORT) in terms of gastrointestinal (GI) or genitourinary (GU) toxicity at two years, according to a study published online March 14 in JAMA Oncology.

Mark K. Buyyounouski, M.D., from Stanford University School of Medicine in California, and colleagues randomly assigned 296 patients with prostate cancer to receive 62.5 Gy in 25 fractions (HYPORT; 144 patients) or 66.6 Gy in 37 fractions (COPORT; 152 patients).

The researchers found that the mean GU change scores were neither clinically significant nor different in statistical significance at the end of radiotherapy in the HYPORT and COPORT arms and remained so at six and 12 months. At the end of radiotherapy, the mean GI change scores for HYPORT and COPORT were clinically significant and different in statistical significance (−15.52 and −7.06, respectively); at six and 12 months, the clinically and statistically significant differences between the scores were resolved. Using noninferiority margins of −5 and −6, respectively, the 24-month differences in mean GU and GI change scores for HYPORT were noninferior to COPORT, rejecting the null hypothesis of inferiority. No difference was seen between HYPORT and COPORT for biochemical failure with a median follow-up of 2.1 years for censored patients.

“This study confirms what many doctors have suspected, which is a shorter course of 25 treatments doesn’t compromise quality-of-life compared to 37 treatments,” Buyyounouski said in a statement. “The shorter course only requires a simple adjustment, which means any radiation oncology center can make the switch.”

Several authors disclosed ties to the biopharmaceutical industry.

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