# CHHiP

Source: https://onco.cc/trials/chhip/  
OnCo record `chhip` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

CHHiP showed that four weeks of prostate radiotherapy in 3 Gy fractions is as effective as seven and a half weeks of conventional treatment, and 60 Gy in 20 fractions became the standard of care.

## Summary

CHHiP randomised 3,216 men with localised prostate cancer to 74 Gy in 37 fractions, 60 Gy in 20 or 57 Gy in 19, delivered with intensity-modulated radiotherapy and short-course hormone therapy. Five-year biochemical or clinical failure-free survival was 88.3 percent with 74 Gy and 90.6 percent with 60 Gy, proving non-inferiority; 57 Gy did not. Late bowel and bladder effects were similar (Dearnaley and colleagues, Lancet Oncology 2016), and the 60 Gy schedule was adopted internationally.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-16
- Tags: radiation-wave2
- Registry id: ISRCTN97182923
- Phase: 3
- Setting: Localised prostate cancer: 60 Gy in 20 fractions or 57 Gy in 19 versus 74 Gy in 37 fractions, all with IMRT
- Sponsor: Institute of Cancer Research (UK)
- Enrolled: 3216
- Result: 5-year biochemical or clinical failure-free survival 90.6% (60 Gy in 20) vs 88.3% (74 Gy in 37), non-inferior.
- Outcomes: Biochemical or clinical failure-free survival at 5 years: 60 Gy in 20 fractions 90.6% vs 74 Gy in 37 fractions 88.3%; Freedom from biochemical or clinical failure at 5 years: 60 Gy in 20 fractions 90.6% vs 74 Gy in 37 fractions 88.3% vs 57 Gy in 19 fractions 85.9%, HR 0.84; Cumulative RTOG grade 2 or worse bowel adverse events at 5 years: 60 Gy in 20 fractions 11.9% vs 74 Gy in 37 fractions 13.7% vs 57 Gy in 19 fractions 11.3%; Cumulative RTOG grade 2 or worse bladder adverse events at 5 years: 60 Gy in 20 fractions 11.7% vs 74 Gy in 37 fractions 9.1% vs 57 Gy in 19 fractions 6.6%
- Replication: PROFIT (1,206 men) and RTOG 0415 (1,115 men) reached the same conclusion for moderate hypofractionation; HYPO-RT-PC and PACE-B extended it to seven and five fractions.

## Notes

- CHHiP recruited men with localised pT1b to T3aN0M0 disease and randomised them 1:1:1 to 74 Gy in 37 fractions over 7.4 weeks, 60 Gy in 20 over 4 weeks or 57 Gy in 19 over 3.8 weeks, all with intensity-modulated technique and most with 3 to 6 months of neoadjuvant and concurrent androgen suppression. Median follow-up was 62.4 months. There were no significant differences in the proportion or cumulative incidence of side effects at 5 years on three clinician-reported and one patient-reported measure, and no treatment-related deaths (Lancet Oncology 2016).
- The radiotherapy quality assurance programme, published separately, is part of why the result is trusted: 41 centres completed it, 71 percent required changes to clinical outlining before treatment, and planning errors fell from 55 percent minor and 21 percent major variations pre-trial to 49 percent minor and 6 percent major on-trial (Clinical Oncology 2019).

## Sources

- ISRCTN97182923: https://www.isrctn.com/ISRCTN97182923
- Lancet Oncology 2016: https://doi.org/10.1016/S1470-2045(16)30102-4
- CHHiP 5-year outcomes (Lancet Oncology 2016): https://doi.org/10.1016/S1470-2045(16)30102-4
- CHHiP radiotherapy quality assurance (Clinical Oncology 2019): https://doi.org/10.1016/j.clon.2019.05.009
- ISRCTN registry ISRCTN97182923: https://www.isrctn.com/ISRCTN97182923

## Connected records

- cancers: [Localised prostate cancer, intermediate risk](https://onco.cc/cancers/prostate-intermediate-risk/), [Localised prostate cancer, very low and low risk](https://onco.cc/cancers/prostate-low-risk/), [Prostate cancer](https://onco.cc/cancers/prostate/)
- technologies: [Hypofractionated radiotherapy](https://onco.cc/technologies/hypofractionated-radiotherapy/), [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/)
- institutions: [The Institute of Cancer Research](https://onco.cc/institutions/icr-london/)
- terms: [Alpha/beta ratio](https://onco.cc/terms/alpha-beta-ratio/), [Choosing treatment for localised prostate cancer: what each option costs](https://onco.cc/terms/prostate-treatment-choice-localised/), [How many radiotherapy visits: the prostate fractionation trials](https://onco.cc/terms/prostate-radiotherapy-fractionation/), [Hypofractionation (fewer, larger radiotherapy doses)](https://onco.cc/terms/hypofractionation/)
- trials: [HYPO-RT-PC](https://onco.cc/trials/hypo-rt-pc/), [PACE-B](https://onco.cc/trials/pace-b/), [PARTIQoL](https://onco.cc/trials/partiqol/), [PROFIT (Prostate Fractionated Irradiation Trial)](https://onco.cc/trials/profit-trial/), [RTOG 0415](https://onco.cc/trials/rtog-0415/), [RTOG 94-08](https://onco.cc/trials/rtog-9408/)
- key papers: [CHHiP: conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer](https://onco.cc/key-papers/paper-chhip-lancet-oncol-2016/)

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