***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE To assess in a prospect i ve trial the feasibility and late toxicity of hypofractionated radiotherapy ( RT ) for prostate cancer . METHODS AND MATERIAL S Eligible patients had clinical stage T1c-2cNXM0 disease . They received 60 Gy in 20 fractions over 4 weeks with intensity-modulated radiotherapy including daily on-line image guidance with intraprostatic fiducial markers . RESULTS Between June 2001 and March 2004 , 92 patients were treated with hypofractionated RT .  The cohort had a median prostate-specific antigen value of 7.06 ng/mL. The majority had Gleason grade 5 - 6 ( 38 % ) or 7 ( 59 % ) disease , and 82 patients had T1c-T2a clinical staging . Overall , 29 patients had low-risk , 56 intermediate-risk , and 7 high-risk disease . Severe acute toxicity ( Grade 3 - 4 ) was rare , occurring in only 1 patient . Median follow-up was 38 months . According to the Phoenix definition for biochemical failure , the rate of biochemical control at 14 months was 97 % . According to the previous American Society for Therapeutic Radiology and Oncology definition , biochemical control at 3 years was 76 % . The incidence of late toxicity was low , with no severe ( Grade > or =3 ) toxicity at the most recent assessment . CONCLUSIONS Hypofractionated RT using 60 Gy in 20 fractions over 4 weeks with image guidance is feasible and is associated with low rates of late bladder and rectal toxicity . At early follow-up , biochemical outcome is comparable to that reported for conventionally fractionated controls . The findings are being tested in an ongoing , multicenter , Phase III trial PURPOSE To compare the toxicity and efficacy of hypofractionated ( 62 Gy/20 fractions/5 weeks , 4 fractions per week ) vs. conventional fractionation radiotherapy ( 80 Gy/40 fractions/8 weeks ) in patients with high-risk prostate cancer . METHODS AND MATERIAL S From January 2003 to December 2007 , 168 patients were r and omized to receive either hypofractionated or conventional fractionated schedules of three-dimensional conformal radiotherapy to the prostate and seminal vesicles . All patients received a 9-month course of total and rogen deprivation ( TAD ) , and radiotherapy started 2 months thereafter . RESULTS The median ( range ) follow-up was 32 ( 8 - 66 ) and 35 ( 7 - 64 ) months in the hypofractionation and conventional fractionation arms , respectively . No difference was found for late toxicity between the two treatment groups , with 3-year Grade 2 rates of 17 % and 16 % for gastrointestinal and 14 % and 11 % for genitourinary in the hypofractionation and conventional fractionation groups , respectively . The 3-year freedom from biochemical failure ( FFBF ) rates were 87 % and 79 % in the hypofractionation and conventional fractionation groups , respectively ( p = 0.035 ) . The 3-year FFBF rates in patients at a very high risk ( i.e. , pretreatment prostate-specific antigen ( iPSA ) > 20 ng/mL , Gleason score > or=8 , or T > or=2c ) , were 88 % and 76 % ( p = 0.014 ) in the former and latter arm , respectively . The multivariate Cox analysis confirmed fractionation , iPSA , and Gleason score as significant prognostic factors . CONCLUSIONS Our findings suggest that late toxicity is equivalent between the two treatment groups and that the hypofractionated schedule used in this trial is superior to the conventional fractionation in terms of FFBF PURPOSE The aim of this study was to compare the toxicity and efficacy of radiation therapy ( RT ) for localized carcinoma of the prostate , using a hypofractionated ( 55 Gy/20 fractions/4 weeks ) vs. a conventionally fractionated ( 64 Gy/32 fractions/6.5 weeks ) dose schedule . METHODS AND MATERIAL S A total of 217 patients were r and omized to either the hypofractionated ( 108 patients ) or the conventional ( 109 patients ) dose schedule  , with planning with two-dimensional ( 2D ) CT scan planning methodology in the majority of cases . All patients were followed for a median of 48 ( 6 - 108 ) months . Gastrointestinal ( GI ) and genitourinary ( GU ) toxicity was evaluated before RT and after its completion using modified late effects of normal tissue-subjective , objective , management , analytic ( LENT-SOMA ) scales and the European Organization for Research and Treatment of Cancer sexual function question naire . Efficacy of RT based on clinical , radiologic , and prostate-specific antigen data were also evaluated at baseline and after RT . RESULTS Gastrointestinal and GU toxicity persisted 5 years after RT and did not differ between the two dose schedules other than in regard to urgency of defecation . However , 1-month GI toxicity was not only worse in patients with the hypofractionated RT schedule but also adversely affected daily activities . Nadir prostate-specific antigen values occurred at a median of 18.0 ( 3.0 - 54.0 ) months after RT . A total of 76 biochemical relapses , with or without clinical relapses , have occurred since ; of these , 37 were in the hypofractionated and 39 in the conventional schedule . The 5-year biochemical + /- clinical relapse-free and overall survival was 55.9 % and 85.3 % respectively for all patients , and did not differ between the two schedules . CONCLUSIONS Radiation therapy for prostate carcinoma causes persistent GI toxicity that is largely independent of the two dose schedules . The hypofractionated schedule is equivalent in efficacy to the conventional schedule Purpose To compare the acute toxicities in radical treatment of prostate cancer between conventional schedule ( C-ARM ) with 78 Gy/39 fractions and hypofractionation conformal treatment ( H-ARM ) with 69 Gy/23 fractions . Methods and material This prospect i ve double arm study consisted of 217 patients with prostate cancer , 112 in H-ARM and 105 in C-ARM arm . C-ARM received conventional six- field conformal radiotherapy with 78 Gy in 39 fractions while H-ARM received hypofractionation with 69 Gy in 23 fractions . Weekly assessment of acute reactions was done during treatment and with one , and 3 months using RTOG scale . Univariated analysis was performed to evaluate differences between the incidences of acute reaction in the treatment arms . Variables with p value less than 0.1 were included in the multivariated logistic regression . Results There was no difference between H-ARM versus C-ARM for severity and incidence in genitourinary ( GU ) and gastrointestinal ( GI ) acute toxicity . During the treatment comparing H-ARM with C-ARM no differences was observed for GI toxicity ( grade 0–3 ; H-ARM = 45.5 % , 34 % , 18.7 % and 1.8 % versus C-ARM = 47.6 % , 35.2 % , 17.2 % and 0 ) . For acute GU toxicity no difference was detected between H-ARM ( grade 0–3 ; 22.3 % , 54.5 % , 18.7 % and 4.5 % ) and C-ARM ( grade 0–3 ; 25.8 % , 53.3 % , 17.1 % and 3.8%).At the 3- months follow-up , persistent Grade > = 2 acute GU and GI toxicity were 2.5 % and 1.8 % in H-ARM versus 5.7 % and 3 % in C-ARM ( p > 0.05 ) . In univariated and multivariated analyses , there was not any dosimetric predictor for GI and GU toxicity . Conclusions Our data demonstrate that hypofractionated radiotherapy achieving high biological effective dose using conformal radiotherapy is feasible for prostate cancer , being well tolerated with minimal severe acute toxicity OBJECTIVE To report late toxicity outcomes from a r and omized trial comparing conventional and hypofractionated prostate radiation therapy and to identify dosimetric and clinical parameters associated with late toxicity after hypofractionated treatment . METHODS AND MATERIAL S Men with localized prostate cancer were enrolled in a trial that r and omized men to either conventionally fractionated intensity modulated radiation therapy ( CIMRT , 75.6 Gy in 1.8-Gy fractions ) or to dose-escalated hypofractionated IMRT ( HIMRT , 72 Gy in 2.4-Gy fractions ) . Late ( ≥90 days after completion of radiation therapy ) genitourinary ( GU ) and gastrointestinal ( GI ) toxicity were prospect ively evaluated and scored according to modified Radiation Therapy Oncology Group criteria . RESULTS 101 men received CIMRT and 102 men received HIMRT . The median age was 68 , and the median follow-up time was 6.0 years . Twenty-eight percent had low-risk , 71 % had intermediate-risk , and 1 % had high-risk disease . There was no difference in late GU toxicity in men treated with CIMRT and HIMRT . The actuarial 5-year grade ≥2 GU toxicity was 16.5 % after CIMRT and 15.8 % after HIMRT ( P=.97 ) . There was a nonsignificant numeric increase in late GI toxicity in men treated with HIMRT compared with men treated with CIMRT . The actuarial 5-year grade ≥2 GI toxicity was 5.1 % after CIMRT and 10.0 % after HIMRT ( P=.11 ) . In men receiving HIMRT , the proportion of rectum receiving 36.9 Gy , 46.2 Gy , 64.6 Gy , and 73.9 Gy was associated with the development of late GI toxicity ( P<.05 ) . The 5-year actuarial grade ≥2 GI toxicity was 27.3 % in men with R64.6Gy ≥ 20 % but only 6.0 % in men with R64.6Gy < 20 % ( P=.016 ) . CONCLUSIONS Dose-escalated IMRT using a moderate hypofractionation regimen ( 72 Gy in 2.4-Gy fractions ) can be delivered safely with limited grade 2 or 3 late toxicity . Minimizing the proportion of rectum that receives moderate and high dose decreases the risk of late rectal toxicity after this hypofractionation regimen Purpose : To compare acute gastrointestinal ( GI ) and genitourinary ( GU ) toxicity between patient groups with localized prostate adenocarcinoma , treated with conventionally fractionated ( CFRT ) and hypofractionated ( HFRT ) three-dimensional conformal external-beam radiotherapy ( 3D-CRT ) . Patients and Methods : 91 patients were enrolled into a r and omized study with a minimum follow-up of 3 months . 44 men in the CFRT arm were irradiated with 74 Gy in 37 fractions at 2 Gy per fraction for 7.5 weeks . 47 men in the HFRT arm were treated with 57 Gy in 17 fractions for 3.5 weeks , given as 13 fractions of 3 Gy plus four fractions of 4.5 Gy . The clinical target volume ( CTV ) included the prostate and the base of seminal vesicles . The CTV-to-PTV ( planning target volume ) margin was 8–10 mm . Study patients had portal imaging and /or simulation performed on the first fractions and repeated at least weekly . Results : No acute grade 3 or 4 toxicities were observed . The grade 2 GU acute toxicity proportion was significantly lower in the HFRT arm : 19.1 % versus 47.7 % ( χ2-test , p = 0.003 ) . The grade 2 GU acute toxicity-free survival was significantly better in the HFRT arm ( log-rank test , p = 0.008 ) . The median duration of overall GI acute toxicity was shorter with HFRT : 3 compared to 6 weeks with CFRT ( median test , p = 0.017 ) . Conclusion : In this first evaluation , the HFRT schedule is feasible and induces acceptable or even lower acute toxicity compared with the toxicities in the CFRT schedule . Extended follow-up is needed to justify this fractionation schedule ’s safety in the long term . Ziel : Es soll die Frage beantwortet werden , ob bei der Beh and lung des lokalisierten Adenokarzinoms der Prostata ein hypofraktioniertes Schema ( HFRT ) die gleichen Tumorkontroll- und Nebenwirkungsraten zeigt wie ein konventionelles Schema ( CFRT ) . Hier wird uber die ersten Ergebnisse zu den Nebenwirkungen berichtet . Patienten und Method ik:91 Patienten wurden i m Rahmen einer Studie r and omisiert beh and elt , die minimale Nachbeobachtungszeit lag bei 3 Monaten . I m CFRT-Arm ( 44 Patienten ) betrug die Dosis 74 Gy ( 37 × 2 Gy/d ) , i m HFRT-Arm ( 47 Patienten ) 57 Gy ( 17 × 3 Gy/d , 4 × 4,5 Gy/d ) . Das klinische Zielvolumen ( CTV ) umfasste die Prostata und 
    Output:
    
In terms of efficacy , there is considerable heterogeneity among the studies , and no conclusive results were found concerning the superiority of the hypofractionated option over the normal fractionated option .
In terms of safety , there were no significant differences in the onset of acute genitourinary complications between the 2 treatments .
There were no significant differences in long-term complications based on the type of radiation therapy used , although the studies did have limitations .
To date , there are no conclusive results that show that hypofractionated radiation therapy is more effective or safer than normal fractionated radiation therapy in the treatment of localized prostate cancer