pHART2-RCT was an oddly named, but pragmatic randomized, phase 2 trial that compared simultaneous, moderately hypofractionated and sequential, conventionally fractionated pelvic and prostate radiation for high risk disease. Those in the hypofractionated arm received 68 Gy to the prostate and 48 Gy to the pelvis in 25 fractions while those in the conventional arm received 46 Gy in 23 fractions to the pelvis and 78 Gy in 39 fractions to the prostate. There was no difference in the rate of grade 2+ GI or GU toxicity between HF and CF (37.8% v 45.6%). While there was also no difference in late grade 2+ GI and GU toxicity, the HF arm had a higher cumulative incidence of late grade 3 events at 24 months (8.3% v 2.4%) and 60 months (13.5% v 2.4%). | Glicksman, Int J Radiat Oncol Biol Phys 2023
