{"entity":{"id":"chhip","kind":"trial","name":"CHHiP","aka":[],"tldr":"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.","status":"positive","asOf":"2026-09-16","links":[{"label":"ISRCTN97182923","url":"https://www.isrctn.com/ISRCTN97182923"},{"label":"Lancet Oncology 2016","url":"https://doi.org/10.1016/S1470-2045(16)30102-4"},{"label":"CHHiP 5-year outcomes (Lancet Oncology 2016)","url":"https://doi.org/10.1016/S1470-2045(16)30102-4"},{"label":"CHHiP radiotherapy quality assurance (Clinical Oncology 2019)","url":"https://doi.org/10.1016/j.clon.2019.05.009"},{"label":"ISRCTN registry ISRCTN97182923","url":"https://www.isrctn.com/ISRCTN97182923"}],"tags":["radiation-wave2"],"related":[],"cancers":["prostate","prostate-intermediate-risk","prostate-low-risk"],"sections":[],"technologies":["hypofractionated-radiotherapy","imrt-igrt"],"targets":[],"drugs":[],"companies":[],"institutions":["icr-london"],"pathways":[],"terms":["hypofractionation","alpha-beta-ratio","prostate-radiotherapy-fractionation"],"trials":["profit-trial","rtog-0415","pace-b","hypo-rt-pc"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"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)."],"nct":"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)","result":"5-year biochemical or clinical failure-free survival 90.6% (60 Gy in 20) vs 88.3% (74 Gy in 37), non-inferior.","yearReported":2016,"enrolled":3216,"enrolledBasis":"randomised","enrolledNote":"3,216 men were enrolled from 71 centres between 18 October 2002 and 17 June 2011; the trial is registered as ISRCTN97182923.","outcomes":[{"endpoint":"Biochemical or clinical failure-free survival at 5 years","primary":true,"unit":"%","arms":[{"name":"60 Gy in 20 fractions","n":1074,"value":90.6},{"name":"74 Gy in 37 fractions","n":1065,"value":88.3}]},{"endpoint":"Freedom from biochemical or clinical failure at 5 years","primary":true,"unit":"%","arms":[{"name":"60 Gy in 20 fractions","n":1074,"value":90.6,"note":"Hazard ratio and 90 percent confidence interval are 60 Gy against 74 Gy, non-inferior (pNI=0.0018); 57 Gy against 74 Gy gave 1.20 (0.99 to 1.46, pNI=0.48), non-inferiority not claimed."},{"name":"74 Gy in 37 fractions","n":1065,"value":88.3},{"name":"57 Gy in 19 fractions","n":1077,"value":85.9}],"hr":0.84,"ci":[0.68,1.03],"source":"https://doi.org/10.1016/S1470-2045(16)30102-4"},{"endpoint":"Cumulative RTOG grade 2 or worse bowel adverse events at 5 years","unit":"%","arms":[{"name":"60 Gy in 20 fractions","n":1074,"value":11.9},{"name":"74 Gy in 37 fractions","n":1065,"value":13.7},{"name":"57 Gy in 19 fractions","n":1077,"value":11.3}],"source":"https://doi.org/10.1016/S1470-2045(16)30102-4"},{"endpoint":"Cumulative RTOG grade 2 or worse bladder adverse events at 5 years","unit":"%","arms":[{"name":"60 Gy in 20 fractions","n":1074,"value":11.7},{"name":"74 Gy in 37 fractions","n":1065,"value":9.1},{"name":"57 Gy in 19 fractions","n":1077,"value":6.6}],"source":"https://doi.org/10.1016/S1470-2045(16)30102-4"}],"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."},"route":"/trials/chhip/","neighbours":{"cancer":[{"id":"prostate-intermediate-risk","kind":"cancer","name":"Localised prostate cancer, intermediate risk","route":"/cancers/prostate-intermediate-risk/"},{"id":"prostate-low-risk","kind":"cancer","name":"Localised prostate cancer, very low and low risk","route":"/cancers/prostate-low-risk/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"technology":[{"id":"hypofractionated-radiotherapy","kind":"technology","name":"Hypofractionated radiotherapy","route":"/technologies/hypofractionated-radiotherapy/"},{"id":"imrt-igrt","kind":"technology","name":"IMRT / IGRT (modern external beam)","route":"/technologies/imrt-igrt/"}],"institution":[{"id":"icr-london","kind":"institution","name":"The Institute of Cancer Research","route":"/institutions/icr-london/"}],"term":[{"id":"alpha-beta-ratio","kind":"term","name":"Alpha/beta ratio","route":"/terms/alpha-beta-ratio/"},{"id":"prostate-treatment-choice-localised","kind":"term","name":"Choosing treatment for localised prostate cancer: what each option costs","route":"/terms/prostate-treatment-choice-localised/"},{"id":"prostate-radiotherapy-fractionation","kind":"term","name":"How many radiotherapy visits: the prostate fractionation trials","route":"/terms/prostate-radiotherapy-fractionation/"},{"id":"hypofractionation","kind":"term","name":"Hypofractionation (fewer, larger radiotherapy doses)","route":"/terms/hypofractionation/"}],"trial":[{"id":"hypo-rt-pc","kind":"trial","name":"HYPO-RT-PC","route":"/trials/hypo-rt-pc/"},{"id":"pace-b","kind":"trial","name":"PACE-B","route":"/trials/pace-b/"},{"id":"partiqol","kind":"trial","name":"PARTIQoL","route":"/trials/partiqol/"},{"id":"profit-trial","kind":"trial","name":"PROFIT (Prostate Fractionated Irradiation Trial)","route":"/trials/profit-trial/"},{"id":"rtog-0415","kind":"trial","name":"RTOG 0415","route":"/trials/rtog-0415/"},{"id":"rtog-9408","kind":"trial","name":"RTOG 94-08","route":"/trials/rtog-9408/"}],"paper":[{"id":"paper-chhip-lancet-oncol-2016","kind":"paper","name":"CHHiP: conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer","route":"/key-papers/paper-chhip-lancet-oncol-2016/"}]}}