Multiple trials have or are investigating ultrahypofractionated pelvic nodal irradiation along with prostate SBRT. A similar question is whether it’s safe to give ultrahypofractionated pelvic nodal irradiation with brachytherapy. In this randomized, phase 3 trial, 142 patients received either 44 Gy in 22 fractions or 25 Gy in 5 fractions along with 15 Gy in 1 fraction HDR brachytherapy. This interim analysis found no significant difference in grade 2-3 GU and GI adverse events between arms. There were no grade 4+ events in either arm, and patient reported outcomes were also similar. Urinary continence and bowel function actually favored the ultrahypofractionated arm in the 12-24 month window. | Fabi, Radiother Oncol 2026
