{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T20:22:55Z","timestamp":1787689375196,"version":"build-2784847793"},"reference-count":38,"publisher":"American Society of Clinical Oncology (ASCO)","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["J Clin Oncol"],"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>To compare hypofractionated radiotherapy (RT) with conventional RT for treating biochemical recurrence following radical prostatectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Between 2019 and 2021, 316 patients with intermediate- to high-risk prostate cancer were randomly assigned to receive salvage RT with either 65 Gy in 26 fractions (hypofractionated RT, HYPO) or 66 Gy in 33 fractions (conventional RT, CONV). RT was delivered to the prostate bed, with elective pelvic nodal irradiation performed at the discretion of radiation oncologists. Intensity-modulated RT with daily image guidance was used. The primary end point was biochemical progression-free survival (bPFS). Secondary end points included distant metastasis-free survival (DMFS), prostate cancer\u2013specific survival (CSS), toxicity profiles, and patient-reported quality-of-life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      One hundred fifty-one patients (51.2%) received androgen deprivation therapy, and 202 (68.5%) underwent elective nodal irradiation. Endorectal balloons were used in 186 men (63.1%). The median pre-RT prostate-specific antigen level was 0.36 ng\/mL (IQR, 0.24-0.49 ng\/mL). After a median follow-up of 52.6 months, the 4-year bPFS rates were 80.1% and 78.1% in the HYPO and CONV arms, respectively. There were no significant differences in DMFS (91.7%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      91.0%) and CSS (100%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      100%). The 4-year cumulative incidence of grade \u22652 GI toxicity was higher in the HYPO arm (7.9%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      0.7%), predominantly among patients without an endorectal balloon; all cases were resolved by the last follow-up. Patient-reported quality-of-life outcomes were comparable.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>bPFS was not superior in the HYPO arm at 4 years. However, given the comparable oncologic outcomes, toxicity profiles, and quality-of-life measures, hypofractionated RT may be considered a viable alternative in the salvage setting. Further research is needed to determine whether the use of an endorectal balloon reduces GI toxicity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco-25-02234","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T19:59:08Z","timestamp":1787687948000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Salvage Hypofractionated Accelerated Versus Standard Radiotherapy for Biochemical Recurrence After Radical Prostatectomy: A Phase III Randomized Clinical Trial"],"prefix":"10.1200","clinical-trial-number":[{"clinical-trial-number":"nct03920033","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9547-5426","authenticated-orcid":true,"given":"Youngju","family":"Song","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8404-7890","authenticated-orcid":true,"given":"Hongryull","family":"Pyo","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2858-0644","authenticated-orcid":true,"given":"Yeon Joo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7608-5352","authenticated-orcid":true,"given":"Hanjong","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"},{"name":"Department of Urology, Kangwon National University Hospital, Chuncheon-si, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1916-7014","authenticated-orcid":true,"given":"Hwa Jung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics &amp; Statistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4739-4476","authenticated-orcid":true,"given":"Young Seok","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"e_1_3_9_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)63946-8"},{"key":"e_1_3_9_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31952-8"},{"key":"e_1_3_9_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31553-1"},{"key":"e_1_3_9_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30454-X"},{"key":"e_1_3_9_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30456-3"},{"key":"e_1_3_9_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.299.23.2760"},{"key":"e_1_3_9_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.10.077"},{"key":"e_1_3_9_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01790-6"},{"key":"e_1_3_9_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.10.008"},{"key":"e_1_3_9_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.10.075"},{"key":"e_1_3_9_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30102-4"},{"key":"e_1_3_9_13_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.67.0448"},{"key":"e_1_3_9_14_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.71.7397"},{"key":"e_1_3_9_15_2","first-page":"4537","article-title":"Hypofractionation with VMAT versus 3DCRT in post-operative patients with prostate cancer","volume":"33","author":"Alongi F","year":"2013","unstructured":"Alongi F, Cozzi L, Fogliata A, et al: Hypofractionation with VMAT versus 3DCRT in post-operative patients with prostate cancer. Anticancer Res 33:4537-4543, 2013","journal-title":"Anticancer Res"},{"key":"e_1_3_9_16_2","first-page":"2785","article-title":"Hypofractionated intensity-modulated radiotherapy with simultaneous integrated boost after radical prostatectomy: Preliminary results of a phase II trial","volume":"33","author":"Massaccesi M","year":"2013","unstructured":"Massaccesi M, Cilla S, Deodato F, et al: Hypofractionated intensity-modulated radiotherapy with simultaneous integrated boost after radical prostatectomy: Preliminary results of a phase II trial. Anticancer Res 33:2785-2789, 2013","journal-title":"Anticancer Res"},{"key":"e_1_3_9_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2018.08.016"},{"key":"e_1_3_9_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2023.7291"},{"key":"e_1_3_9_19_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2025.0052"},{"key":"e_1_3_9_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.02.006"},{"key":"e_1_3_9_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.08.002"},{"key":"e_1_3_9_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2016.10.026"},{"key":"e_1_3_9_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2018.02.002"},{"key":"e_1_3_9_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25824"},{"key":"e_1_3_9_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.11.025"},{"key":"e_1_3_9_26_2","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S182016"},{"key":"e_1_3_9_27_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1607529"},{"key":"e_1_3_9_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00549-X"},{"key":"e_1_3_9_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2011.07.019"},{"key":"e_1_3_9_30_2","first-page":"3095","article-title":"Analysis of prostate bed motion using an endorectal balloon and cone beam computed tomography during postprostatectomy radiotherapy","volume":"9","author":"Joo JH","year":"2016","unstructured":"Joo JH, Kim YJ, Kim YS, et al: Analysis of prostate bed motion using an endorectal balloon and cone beam computed tomography during postprostatectomy radiotherapy. Onco Targets Ther 9:3095-3100, 2016","journal-title":"Onco Targets Ther"},{"key":"e_1_3_9_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2021.05.033"},{"key":"e_1_3_9_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2025.04.002"},{"key":"e_1_3_9_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2019.06.127"},{"key":"e_1_3_9_34_2","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.117.201749"},{"key":"e_1_3_9_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2020.04.004"},{"key":"e_1_3_9_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2024.01.012"},{"key":"e_1_3_9_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2022.08.041"},{"key":"e_1_3_9_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctro.2023.100704"},{"key":"e_1_3_9_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2025.05.014"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO-25-02234","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T19:59:15Z","timestamp":1787687955000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO-25-02234"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,25]]},"references-count":38,"alternative-id":["10.1200\/JCO-25-02234"],"URL":"https:\/\/doi.org\/10.1200\/jco-25-02234","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,25]]},"assertion":[{"value":"2025-10-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-23","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"JCO-25-02234"}}