trialsTrialPositive

CHHiP

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.

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.

Setting

Localised prostate cancer: 60 Gy in 20 fractions or 57 Gy in 19 versus 74 Gy in 37 fractions, all with IMRT

Phase

Phase 3

Sponsor

Institute of Cancer Research (UK)

Registry

ISRCTN97182923

Headline result

5-year biochemical or clinical failure-free survival 90.6% (60 Gy in 20) vs 88.3% (74 Gy in 37), non-inferior.

Reported

2016

Enrolled

3,216 randomised3,216 men were enrolled from 71 centres between 18 October 2002 and 17 June 2011; the trial is registered as ISRCTN97182923.

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.

Outcomes

4top

In plain words

What these results mean for people, not percentages

3,216 randomised

Biochemical or clinical failure-free survival at 5 yearsprimarysurvival endpoint

90.6 vs 88.3 out of 100 alive at 5 years with 60 Gy in 20 fractions compared with 74 Gy in 37 fractions; 2.3 more per 100.
Roughly one extra person helped for every 43 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.

Overall survival counts deaths from any cause, so it is the most direct measure of whether a treatment helps people live longer.

Freedom from biochemical or clinical failure at 5 yearsprimaryother endpoint

90.6 vs 88.3 out of 100 reached this endpoint at 5 years with 60 Gy in 20 fractions compared with 74 Gy in 37 fractions; 2.3 more per 100.
Roughly one extra person helped for every 43 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
Other groups: 57 Gy in 19 fractions 85.9 of 100.
Put another way, the treated group had about 16 percent lower chance of the event at any given time (hazard ratio 0.84, likely range 0.68 to 1.03).

The likely range for the hazard ratio crosses 1, so the difference could be due to chance.
This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.

Cumulative RTOG grade 2 or worse bowel adverse events at 5 yearsother endpoint

11.9 vs 13.7 out of 100 reached this endpoint at 5 years with 60 Gy in 20 fractions compared with 74 Gy in 37 fractions; 1.8 fewer per 100.
Roughly one extra person helped for every 56 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
Other groups: 57 Gy in 19 fractions 11.3 of 100.

This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.

Cumulative RTOG grade 2 or worse bladder adverse events at 5 yearsother endpoint

11.7 vs 9.1 out of 100 reached this endpoint at 5 years with 60 Gy in 20 fractions compared with 74 Gy in 37 fractions; 2.6 more per 100.
On this measure the first group did worse, not better.
Other groups: 57 Gy in 19 fractions 6.6 of 100.

This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.

Caveats

These results apply to the people the trial enrolled: Localised prostate cancer: 60 Gy in 20 fractions or 57 Gy in 19 versus 74 Gy in 37 fractions, all with IMRT. People in a different situation may not see the same effect.

Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.

3,216 randomised.

Biochemical or clinical failure-free survival at 5 yearsprimary

60 Gy in 20 fractions90.6 of 100

n = 1,074

74 Gy in 37 fractions88.3 of 100

n = 1,065

Download

Freedom from biochemical or clinical failure at 5 yearsprimary

HR 0.84 (0.68 to 1.03)

60 Gy in 20 fractions90.6 of 100

n = 1,074

74 Gy in 37 fractions88.3 of 100

n = 1,065

57 Gy in 19 fractions85.9 of 100

n = 1,077

Download

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.

Source

Cumulative RTOG grade 2 or worse bowel adverse events at 5 years

60 Gy in 20 fractions11.9 of 100

n = 1,074

74 Gy in 37 fractions13.7 of 100

n = 1,065

57 Gy in 19 fractions11.3 of 100

n = 1,077

Download

Source

Cumulative RTOG grade 2 or worse bladder adverse events at 5 years

60 Gy in 20 fractions11.7 of 100

n = 1,074

74 Gy in 37 fractions9.1 of 100

n = 1,065

57 Gy in 19 fractions6.6 of 100

n = 1,077

Download

Source

Endpoint	Arm	n	Value	HR (95% CI)	p	Source
Biochemical or clinical failure-free survival at 5 yearsprimary	60 Gy in 20 fractions	1,074	90.6%	-	-	-
	74 Gy in 37 fractions	1,065	88.3%	-	-	-
Freedom from biochemical or clinical failure at 5 yearsprimary	60 Gy in 20 fractions	1,074	90.6%	0.84 (0.68 to 1.03)	-	link
	74 Gy in 37 fractions	1,065	88.3%
	57 Gy in 19 fractions	1,077	85.9%
Cumulative RTOG grade 2 or worse bowel adverse events at 5 years	60 Gy in 20 fractions	1,074	11.9%	-	-	link
	74 Gy in 37 fractions	1,065	13.7%
	57 Gy in 19 fractions	1,077	11.3%
Cumulative RTOG grade 2 or worse bladder adverse events at 5 years	60 Gy in 20 fractions	1,074	11.7%	-	-	link
	74 Gy in 37 fractions	1,065	9.1%
	57 Gy in 19 fractions	1,077	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

top

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).

Key papers

1top

rctThe Lancet Oncology 2016changed practice1,004 citations

CHHiP: conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer

Moderate hypofractionation (60 Gy in 20 fractions) is a standard of care for localised prostate cancer, halving the number of hospital visits.

Connected

17top

Trial
START-B (UK Standardisation of Breast Radiotherapy)
Shares Alpha/beta ratio, Hypofractionation (fewer, larger radiotherapy doses), Hypofractionated radiotherapy, The Institute of Cancer Research and the tag radiation-wave2.
Trial
FAST-Forward
Shares Hypofractionation (fewer, larger radiotherapy doses), Hypofractionated radiotherapy, IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Trial
IMPORT LOW
Shares Hypofractionated radiotherapy, The Institute of Cancer Research, IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Trial
CATNON (EORTC 26053-22054)
Shares IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Trial
PRIME II
Shares IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Trial
NRG CC001
Shares IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Trial
NSABP B-39/RTOG 0413
Shares IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Trial
RTOG 0617
Shares IMRT / IGRT (modern external beam) and the tag radiation-wave2.

Evidence strength81/100 · Strong

How much and what kind of evidence, not how big the benefit. Click for the breakdown.

Phase 3+30
3,216 enrolled+18
Primary endpoint: surrogate (response, pCR, detection)+8
Result: positive+15
Independent replication or consistent trials+10

Formula disclosed on the evidence page.

ProvenanceLast edited 2026-09-25 · Jude Gomila · Prostate treatment from its trials · diff · file

Sources & links

CHHiP

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.

Setting

Localised prostate cancer: 60 Gy in 20 fractions or 57 Gy in 19 versus 74 Gy in 37 fractions, all with IMRT

Phase

Phase 3

Sponsor

Institute of Cancer Research (UK)

Registry

ISRCTN97182923

Headline result

5-year biochemical or clinical failure-free survival 90.6% (60 Gy in 20) vs 88.3% (74 Gy in 37), non-inferior.

Reported

2016

Enrolled

3,216 randomised3,216 men were enrolled from 71 centres between 18 October 2002 and 17 June 2011; the trial is registered as ISRCTN97182923.

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.

Outcomes

4top

In plain words

What these results mean for people, not percentages

3,216 randomised

Biochemical or clinical failure-free survival at 5 yearsprimarysurvival endpoint

90.6 vs 88.3 out of 100 alive at 5 years with 60 Gy in 20 fractions compared with 74 Gy in 37 fractions; 2.3 more per 100.
Roughly one extra person helped for every 43 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.

Overall survival counts deaths from any cause, so it is the most direct measure of whether a treatment helps people live longer.

Freedom from biochemical or clinical failure at 5 yearsprimaryother endpoint

90.6 vs 88.3 out of 100 reached this endpoint at 5 years with 60 Gy in 20 fractions compared with 74 Gy in 37 fractions; 2.3 more per 100.
Roughly one extra person helped for every 43 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
Other groups: 57 Gy in 19 fractions 85.9 of 100.
Put another way, the treated group had about 16 percent lower chance of the event at any given time (hazard ratio 0.84, likely range 0.68 to 1.03).

The likely range for the hazard ratio crosses 1, so the difference could be due to chance.
This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.

Cumulative RTOG grade 2 or worse bowel adverse events at 5 yearsother endpoint

11.9 vs 13.7 out of 100 reached this endpoint at 5 years with 60 Gy in 20 fractions compared with 74 Gy in 37 fractions; 1.8 fewer per 100.
Roughly one extra person helped for every 56 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
Other groups: 57 Gy in 19 fractions 11.3 of 100.

This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.

Cumulative RTOG grade 2 or worse bladder adverse events at 5 yearsother endpoint

11.7 vs 9.1 out of 100 reached this endpoint at 5 years with 60 Gy in 20 fractions compared with 74 Gy in 37 fractions; 2.6 more per 100.
On this measure the first group did worse, not better.
Other groups: 57 Gy in 19 fractions 6.6 of 100.

This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.

Caveats

These results apply to the people the trial enrolled: Localised prostate cancer: 60 Gy in 20 fractions or 57 Gy in 19 versus 74 Gy in 37 fractions, all with IMRT. People in a different situation may not see the same effect.

Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.

3,216 randomised.

Biochemical or clinical failure-free survival at 5 yearsprimary

60 Gy in 20 fractions90.6 of 100

n = 1,074

74 Gy in 37 fractions88.3 of 100

n = 1,065

Download

Freedom from biochemical or clinical failure at 5 yearsprimary

HR 0.84 (0.68 to 1.03)

60 Gy in 20 fractions90.6 of 100

n = 1,074

74 Gy in 37 fractions88.3 of 100

n = 1,065

57 Gy in 19 fractions85.9 of 100

n = 1,077

Download

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.

Source

Cumulative RTOG grade 2 or worse bowel adverse events at 5 years

60 Gy in 20 fractions11.9 of 100

n = 1,074

74 Gy in 37 fractions13.7 of 100

n = 1,065

57 Gy in 19 fractions11.3 of 100

n = 1,077

Download

Source

Cumulative RTOG grade 2 or worse bladder adverse events at 5 years

60 Gy in 20 fractions11.7 of 100

n = 1,074

74 Gy in 37 fractions9.1 of 100

n = 1,065

57 Gy in 19 fractions6.6 of 100

n = 1,077

Download

Source

Endpoint	Arm	n	Value	HR (95% CI)	p	Source
Biochemical or clinical failure-free survival at 5 yearsprimary	60 Gy in 20 fractions	1,074	90.6%	-	-	-
	74 Gy in 37 fractions	1,065	88.3%	-	-	-
Freedom from biochemical or clinical failure at 5 yearsprimary	60 Gy in 20 fractions	1,074	90.6%	0.84 (0.68 to 1.03)	-	link
	74 Gy in 37 fractions	1,065	88.3%
	57 Gy in 19 fractions	1,077	85.9%
Cumulative RTOG grade 2 or worse bowel adverse events at 5 years	60 Gy in 20 fractions	1,074	11.9%	-	-	link
	74 Gy in 37 fractions	1,065	13.7%
	57 Gy in 19 fractions	1,077	11.3%
Cumulative RTOG grade 2 or worse bladder adverse events at 5 years	60 Gy in 20 fractions	1,074	11.7%	-	-	link
	74 Gy in 37 fractions	1,065	9.1%
	57 Gy in 19 fractions	1,077	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

top

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).

Key papers

1top

rctThe Lancet Oncology 2016changed practice1,004 citations

CHHiP: conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer

Moderate hypofractionation (60 Gy in 20 fractions) is a standard of care for localised prostate cancer, halving the number of hospital visits.

Connected

17top

Trial
START-B (UK Standardisation of Breast Radiotherapy)
Shares Alpha/beta ratio, Hypofractionation (fewer, larger radiotherapy doses), Hypofractionated radiotherapy, The Institute of Cancer Research and the tag radiation-wave2.
Trial
FAST-Forward
Shares Hypofractionation (fewer, larger radiotherapy doses), Hypofractionated radiotherapy, IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Trial
IMPORT LOW
Shares Hypofractionated radiotherapy, The Institute of Cancer Research, IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Trial
CATNON (EORTC 26053-22054)
Shares IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Trial
PRIME II
Shares IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Trial
NRG CC001
Shares IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Trial
NSABP B-39/RTOG 0413
Shares IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Trial
RTOG 0617
Shares IMRT / IGRT (modern external beam) and the tag radiation-wave2.

cancers

Localised prostate cancer, intermediate risk Localised prostate cancer, very low and low risk Prostate cancer

technologies

Hypofractionated radiotherapy IMRT / IGRT (modern external beam)

institutions

The Institute of Cancer Research

terms

trials

HYPO-RT-PC PACE-B PARTIQoL PROFIT (Prostate Fractionated Irradiation Trial)RTOG 0415 RTOG 94-08

key papers

CHHiP: conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer

Evidence strength81/100 · Strong

How much and what kind of evidence, not how big the benefit. Click for the breakdown.

Phase 3+30
3,216 enrolled+18
Primary endpoint: surrogate (response, pCR, detection)+8
Result: positive+15
Independent replication or consistent trials+10

Formula disclosed on the evidence page.

ProvenanceLast edited 2026-09-25 · Jude Gomila · Prostate treatment from its trials · diff · file

Sources & links

CHHiP

Outcomes

Notes

Key papers

Connected

Similar pages

cancers

technologies

institutions

terms

trials

key papers

CHHiP

Outcomes

Notes

Key papers

Connected

Similar pages

cancers

technologies

institutions

terms

trials

key papers

CHHiP

Overview

Outcomes

Notes

Key papers

Connected

Similar pages

cancers

technologies

institutions

terms

trials

key papers

CHHiP

Overview

Outcomes

Notes

Key papers

Connected

Similar pages

cancers

technologies

institutions

terms

trials

key papers