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However, international guidelines are not congruent regarding recommendation of ultrahypofractionated radiotherapy (UHF-RT) to all risk groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>The current review gives an overview of clinically relevant\u00a0toxicity extracted from\u00a0major randomized controlled trials (RCT) trials comparing conventional to hypofractionated regimes in the primary setting of external photon radiation. Functional impairments\u00a0are\u00a0reported by\u00a0using physician-rated and patient-reported scores using\u00a0validated questionnaires.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The uncertain radiobiology of the urethra\/bladder when applying extreme hypofractionation may have contributed to worse acute urinary toxicity score in the Scandinavian UHF-RT and worse subacute toxicity in PACE-B. The observed trend of increased acute GI toxicity in several moderate Hypo-RT trials and one UHF-RT trial, the Scandinavian Hypo-RT PC trial, could be associated to the different planning margins and radiation dose schedules.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Nevertheless, Hypo-RT has gained ground for patients with localized PCa and further improvements may be achieved by inclusion of genetically assessed radiation sensitivity. Several RCTs in Hypo-RT have shown non-inferior outcome and well-tolerated treatment toxicity by physician-rated scores. In the future, we suggest that toxicity should be measured by patient-reported outcome (PRO) using comparable questionnaires.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00345-023-04714-3","type":"journal-article","created":{"date-parts":[[2024,1,20]],"date-time":"2024-01-20T10:02:28Z","timestamp":1705744948000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Acute and long-term toxicity in primary hypofractionated external photon radiation therapy in patients with localized prostate cancer"],"prefix":"10.1007","volume":"42","author":[{"given":"Wolfgang","family":"Lilleby","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amar","family":"Kishan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Geinitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,1,20]]},"reference":[{"issue":"8","key":"4714_CR1","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1016\/S1470-2045(16)30102-4","volume":"17","author":"D Dearnaley","year":"2016","unstructured":"Dearnaley D, Syndikus I, Mossop H, Khoo V, Birtle A, Bloomfield D, Graham J, Kirkbride P, Logue J, Malik Z et al (2016) Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: 5-year outcomes of the randomised, non-inferiority, phase 3 CHHiP trial. 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