{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T11:17:29Z","timestamp":1784546249361,"version":"3.55.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Prostate cancer is the most frequently diagnosed male malignancy in Colombia. While modern radiotherapy techniques allow for hypofractionated schedules due to the low alpha\/beta ratio of prostate adenocarcinoma, real-world comparative data between moderate and ultra-hypofractionation in Latin American settings remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare acute and early late toxicity in patients with prostate cancer treated with moderately hypofractionated radiotherapy versus those treated with ultra-hypofractionated regimen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comparative historical cohort study was conducted at a Colombian oncology center between 2018 and 2025.\u00a0A total of 229 patients with non-metastatic prostate cancer (T1\u2013T4) were enrolled (MHRT: n=143; UHRT: n=86). Toxicity was graded using CTCAE criteria. Multivariable logistic regression was used to identify independent predictors of toxicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Acute toxicity was significantly higher in the MHRT group compared to the UHRT group (25.17% vs. 11.63%; p=0.013). Similarly, late toxicity was more frequent in the MHRT group (37.06% vs. 9.30%; p&amp;lt;0.001), with erectile dysfunction as the most common late event. Multivariable analysis showed that UHRT was independently associated with lower odds of acute toxicity (aOR 0.44; 95% CI 0.19\u20130.99; p=0.048).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>UHRT showed a generally favorable safety profile, with trends toward lower acute and late toxicity compared to MHRT. In middle-income settings such as Colombia, UHRT may offer a practical approach to enhance treatment efficiency and patient access, while maintaining acceptable clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1843032","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T04:57:27Z","timestamp":1779425847000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Acute and late toxicity in prostate cancer patients treated with moderately vs ultra-hypofractionated radiotherapy"],"prefix":"10.3389","volume":"16","author":[{"given":"Javier","family":"Cifuentes-Quin","sequence":"first","affiliation":[{"name":"Oncology Department, Hospital Internacional de Colombia HIC - Fundaci\u00f3n Cardiovascular de Colombia FCV - Fundaci\u00f3n Universitaria FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiselle T.","family":"Garcia-Monta\u00f1ez","sequence":"additional","affiliation":[{"name":"Oncology Department, Hospital Internacional de Colombia HIC - Fundaci\u00f3n Cardiovascular de Colombia FCV - Fundaci\u00f3n Universitaria FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Hurtado-Ortiz","sequence":"additional","affiliation":[{"name":"Epidemiology Department, Hospital Internacional de Colombia HIC - Fundaci\u00f3n Cardiovascular de Colombia FCV - Fundaci\u00f3n Universitaria Fundaci\u00f3n Cardiovascular de Colombia FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jhonatan","family":"Cruz","sequence":"additional","affiliation":[{"name":"Oncology Department, Hospital Internacional de Colombia HIC - Fundaci\u00f3n Cardiovascular de Colombia FCV - Fundaci\u00f3n Universitaria FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Carlos","family":"Lagares","sequence":"additional","affiliation":[{"name":"Oncology Department, Hospital Internacional de Colombia HIC - Fundaci\u00f3n Cardiovascular de Colombia FCV - Fundaci\u00f3n Universitaria FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis A.","family":"Olarte-Licht","sequence":"additional","affiliation":[{"name":"Epidemiology Department, Hospital Internacional de Colombia HIC - Fundaci\u00f3n Cardiovascular de Colombia FCV - Fundaci\u00f3n Universitaria Fundaci\u00f3n Cardiovascular de Colombia FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maricel","family":"Licht-Ardila","sequence":"additional","affiliation":[{"name":"Epidemiology Department, Hospital Internacional de Colombia HIC - Fundaci\u00f3n Cardiovascular de Colombia FCV - Fundaci\u00f3n Universitaria Fundaci\u00f3n Cardiovascular de Colombia FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar Fabi\u00e1n","family":"Manrique-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Epidemiology Department, Hospital Internacional de Colombia HIC - Fundaci\u00f3n Cardiovascular de Colombia FCV - Fundaci\u00f3n Universitaria Fundaci\u00f3n Cardiovascular de Colombia FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA: A Cancer J For Clin"},{"key":"B2","doi-asserted-by":"publisher","first-page":"3","DOI":"10.24875\/ruc.24000051","article-title":"Disease burden and treatment choice for metastatic hormone-sensitive prostate cancer in Colombia","volume":"34","author":"Manneh-Kopp Ray","year":"2025","journal-title":"Urol Colomb"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/s0360-3016(02)02857-2","article-title":"High-dose intensity modulated radiation therapy for prostate cancer: early toxicity and biochemical outcome in 772 patients","volume":"53","author":"Zelefsky","year":"2002","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.10.091","article-title":"Higher-than-conventional radiation doses in localized prostate cancer treatment: a meta-analysis of randomized, controlled trials","volume":"74","author":"Viani","year":"2009","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/s0360-3016(98)00438-6","article-title":"Fractionation and protraction for radiotherapy of prostate carcinoma","volume":"43","author":"Brenner","year":"1999","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/s0360-3016(01)01607-8","article-title":"Is alpha\/beta for prostate tumors really low","volume":"50","author":"Fowler","year":"2001","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.10.075","article-title":"Dose-fractionation sensitivity of prostate cancer deduced from radiotherapy outcomes of 5,969 patients in seven international institutional datasets: \u03b1\/\u03b2 = 1.4 (0.9-2.2) Gy","volume":"82","author":"Miralbell","year":"2012","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30102-4","article-title":"Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: 5-year outcomes of the randomised, non-inferiority, phase 3 CHHiP trial","volume":"17","author":"Dearnaley","year":"2016","journal-title":"Lancet Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.71.7397","article-title":"Randomized trial of a hypofractionated radiation regimen for the treatment of localized prostate cancer","volume":"35","author":"Catton","year":"2017","journal-title":"Cancer J Clin Oncol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)00567-7","article-title":"Hypofractionated versus conventionally fractionated radiotherapy for patients with prostate cancer (HYPRO): late toxicity results from a randomised, non-inferiority, phase 3 trial","volume":"17","author":"Aluwini","year":"2016","journal-title":"Lancet Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30569-8","article-title":"Intensity-modulated fractionated radiotherapy versus stereotactic body radiotherapy for prostate cancer (PACE-B): acute toxicity findings from an international, randomised, open-label, phase 3, non-inferiority trial","volume":"20","author":"Brand","year":"2019","journal-title":"Lancet Oncol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.semradonc.2012.11.005","article-title":"Health economic controversy and cost-effectiveness of proton therapy","volume":"23","author":"Lievens","year":"2013","journal-title":"Semin Radiat Oncol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.5603\/ocp.108586","article-title":"Acute and late toxicity in prostate cancer patients treated with moderately hypofractionated radiotherapy","volume":"22","author":"Cifuentes-Quin","year":"2026","journal-title":"Oncol Clin Pract"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21388","article-title":"The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more \u201cpersonalized\u201d approach to cancer staging","volume":"67","author":"Amin","year":"2017","journal-title":"A Cancer J For Clin"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.09.042","article-title":"EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer-2020 Update. Part 1: Screening, diagnosis, and local treatment with curative intent","volume":"79","author":"Mottet","year":"2021","journal-title":"Eur Urol"},{"key":"B16","unstructured":"Guidelines Detail"},{"key":"B17","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1016\/S1470-2045(25)00656-4","article-title":"Ultra-hypofractionated versus conventionally fractionated radiotherapy for localised prostate cancer (HYPO-RT-PC): 10-year outcomes of an open-label, randomised, phase 3, non-inferiority trial","volume":"27","author":"Nilsson","year":"2026","journal-title":"Lancet Oncol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/S1470-2045(11)70293-5","article-title":"Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: preliminary safety results from the CHHiP randomised controlled trial","volume":"13","author":"Dearnaley","year":"2012","journal-title":"Lancet Oncol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"3557","DOI":"10.1007\/s00432-021-03785-2","article-title":"Five-year outcomes of stereotactic body radiation therapy (SBRT) for prostate cancer: the largest experience in China","volume":"147","author":"Zhao","year":"2021","journal-title":"J Cancer Res Clin Oncol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2023.05.004","article-title":"Toxicity and patient-reported quality-of-life outcomes after prostate stereotactic body radiation therapy with focal boost to magnetic resonance imaging-identified prostate cancer lesions: Results of a phase 2 trial","volume":"117","author":"Morris","year":"2023","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.8006","article-title":"Long-term outcomes of stereotactic body radiotherapy for low-risk and intermediate-risk prostate cancer","volume":"2","author":"Kishan","year":"2019","journal-title":"JAMA Netw Open"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.phro.2023.100421","article-title":"Predictors for late genitourinary toxicity in men receiving radiotherapy for high-risk prostate cancer using planned and accumulated dose","volume":"25","author":"Ong","year":"2023","journal-title":"Phys Imaging Radiat Oncol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2018.08.002","article-title":"Hypofractionated radiation therapy for localized prostate cancer: Executive summary of an ASTRO, ASCO, and AUA evidence-based guideline","volume":"8","author":"Morgan","year":"2018","journal-title":"Pract Radiat Oncol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.24875\/j.gamo.25000028","article-title":"Timeliness in cancer care: an analysis of delays in diagnosis and treatment initiation","volume":"24","author":"Ballesteros-Goes","year":"2025","journal-title":"Mexican J Oncol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2014.03.002","article-title":"Radiation therapy infrastructure and human resources in low- and middle-income countries: present status and projections for 2020","volume":"89","author":"Datta","year":"2014","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2013.08.030","article-title":"Stereotactic body radiotherapy for localized prostate cancer: pooled analysis from a multi-institutional consortium of prospective phase II trials","volume":"109","author":"King","year":"2013","journal-title":"Radiother Oncol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2019.03.051","article-title":"Stereotactic body radiation therapy for localized prostate cancer: a systematic review and meta-analysis of over 6,000 patients treated on prospective studies","volume":"104","author":"Jackson","year":"2019","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200006223422507","article-title":"Randomized, controlled trials, observational studies, and the hierarchy of research designs","volume":"342","author":"Concato","year":"2000","journal-title":"N Engl J Med"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"370","author":"von Elm","year":"2007","journal-title":"Lancet"},{"key":"B30","first-page":"165","article-title":"Clinical insights for image-guided radiotherapy: Prostate","volume-title":"CRC Press","author":"Kirby","year":"2024"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1843032\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T04:57:32Z","timestamp":1779425852000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1843032\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,22]]},"references-count":30,"alternative-id":["10.3389\/fonc.2026.1843032"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1843032","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,22]]},"article-number":"1843032"}}