# FoRT

Source: https://onco.cc/trials/fort/  
OnCo record `fort` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

FoRT asked whether two very small doses of radiotherapy control follicular lymphoma as well as the standard twelve; they do not, with about three times the rate of regrowth in the treated area, so 24 Gy stays the standard when the aim is lasting control and 4 Gy is kept for palliation.

## Summary

FoRT was a UK phase 3 non-inferiority trial that randomised 614 target sites in 548 patients with follicular or marginal zone lymphoma to 24 Gy in 12 fractions or 4 Gy in 2 fractions. The primary endpoint was time to local progression within the irradiated volume; the trial allowed both curative-intent and palliative treatment.

At the first report 4 Gy failed non-inferiority, with a hazard ratio of 3.42 for local progression. Long-term follow-up at a median of 73.8 months confirmed the difference: local progression-free rates were 94.1 percent at two years and 89.9 percent at five years after 24 Gy against 79.8 and 70.4 percent after 4 Gy. The corpus's follicular lymphoma page names involved-site radiotherapy of 24 Gy for localised disease on this evidence, while 4 Gy remains a useful palliative option.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-22
- Also known as: FORT; FoRT trial
- Tags: soc-trials
- Registry id: NCT00310167
- Phase: 3
- Setting: Follicular or marginal zone lymphoma needing local radiotherapy for cure or palliation, in 43 UK centres: 24 Gy in 12 fractions against 4 Gy in 2 fractions to the same site, with time to local progression in the irradiated field as the primary endpoint (non-inferiority)
- Sponsor: University College, London
- Enrolled: 548
- Result: 4 Gy was not non-inferior to 24 Gy for local control: five-year local progression-free rate 89.9 percent after 24 Gy against 70.4 percent after 4 Gy (hazard ratio 3.46).
- Outcomes: Local progression-free rate at 5 years in the irradiated site: 24 Gy in 12 fractions 89.9% vs 4 Gy in 2 fractions 70.4%, HR 3.46; Local progression-free rate at 2 years in the irradiated site: 24 Gy in 12 fractions 94.1% vs 4 Gy in 2 fractions 79.8%; Time to local progression, first analysis (hazard for 4 Gy against 24 Gy): 4 Gy in 2 fractions vs 24 Gy in 12 fractions, HR 3.42

## Sources

- ClinicalTrials.gov NCT00310167: https://clinicaltrials.gov/study/NCT00310167

## Connected records

- cancers: [Follicular lymphoma](https://onco.cc/cancers/follicular-lymphoma/), [Marginal zone lymphoma](https://onco.cc/cancers/marginal-zone-lymphoma/), [Non-Hodgkin lymphoma (all types)](https://onco.cc/cancers/non-hodgkin-lymphoma/)
- technologies: [Hypofractionated radiotherapy](https://onco.cc/technologies/hypofractionated-radiotherapy/), [Palliative radiotherapy](https://onco.cc/technologies/palliative-radiotherapy/)
- institutions: [University College London Hospitals / UCL Cancer Institute](https://onco.cc/institutions/uclh/)
- key papers: [FoRT long-term follow-up: 4 Gy versus 24 Gy for follicular and marginal zone lymphoma](https://onco.cc/key-papers/paper-fort-long-term-follow-up-hoskin-lancet-oncol-2021/), [FoRT: 4 Gy versus 24 Gy radiotherapy for indolent lymphoma, a randomised phase 3 non-inferiority trial](https://onco.cc/key-papers/paper-fort-4gy-vs-24gy-indolent-lymphoma-hoskin-lancet-oncol-2014/)

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