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

Source: https://onco.cc/key-papers/paper-chhip-lancet-oncol-2016/  
OnCo record `paper-chhip-lancet-oncol-2016` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Delivering prostate radiotherapy in 20 larger daily doses over four weeks was as effective as 37 smaller doses over seven and a half weeks, with no more side effects, and became the standard schedule in many countries.

## Summary

Phase 3 non-inferiority trial of 3,216 men with localised prostate cancer (mostly intermediate risk) randomised to 74 Gy in 37 fractions, 60 Gy in 20 fractions or 57 Gy in 19 fractions of intensity-modulated radiotherapy with short-course androgen deprivation.

Five-year biochemical or clinical failure-free rates were 88.3 percent (74 Gy), 90.6 percent (60 Gy) and 85.9 percent (57 Gy); 60 Gy in 20 fractions was non-inferior and toxicity was similar.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet Oncology
- Year: 2016
- DOI: 10.1016/S1470-2045(16)30102-4
- Authors: Dearnaley D, Syndikus I, Mossop H, et al.
- Findings: Five-year failure-free rate 90.6 percent (60 Gy/20) vs 88.3 percent (74 Gy/37); non-inferior.; 57 Gy in 19 fractions did not meet non-inferiority.
- What it means: Moderate hypofractionation (60 Gy in 20 fractions) is a standard of care for localised prostate cancer, halving the number of hospital visits.
- Caveats: Most men received short-course androgen deprivation.; Ultra-hypofractionation (five fractions) was tested separately in PACE-B.

## Sources

- Lancet Oncol 2016: https://doi.org/10.1016/S1470-2045(16)30102-4
- PubMed: https://pubmed.ncbi.nlm.nih.gov/27339115/

## Connected records

- cancers: [Localised prostate cancer, intermediate risk](https://onco.cc/cancers/prostate-intermediate-risk/)
- trials: [CHHiP](https://onco.cc/trials/chhip/)
- journals: [The Lancet Oncology](https://onco.cc/journals/lancet-oncology/)

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