{"entity":{"id":"fort","kind":"trial","name":"FoRT","aka":["FORT","FoRT trial"],"tldr":"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.\n\nAt 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.","status":"positive","asOf":"2026-09-22","links":[{"label":"ClinicalTrials.gov NCT00310167","url":"https://clinicaltrials.gov/study/NCT00310167"}],"tags":["soc-trials"],"related":[],"cancers":["follicular-lymphoma","marginal-zone-lymphoma","non-hodgkin-lymphoma"],"sections":[],"technologies":["hypofractionated-radiotherapy","palliative-radiotherapy"],"targets":[],"drugs":[],"companies":[],"institutions":["uclh"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-fort-4gy-vs-24gy-indolent-lymphoma-hoskin-lancet-oncol-2014","paper-fort-long-term-follow-up-hoskin-lancet-oncol-2021"],"journals":[],"dependsOn":[],"notes":[],"nct":"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","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).","yearReported":2014,"enrolled":548,"enrolledBasis":"randomised","enrolledNote":"The registry counts 614, the number of randomised target sites; the trial randomised 548 patients (some with more than one site) between 2006 and 2011.","outcomes":[{"endpoint":"Local progression-free rate at 5 years in the irradiated site","primary":true,"unit":"%","arms":[{"name":"24 Gy in 12 fractions","n":299,"value":89.9,"note":"95% CI 85.5 to 93.1; 299 sites randomised"},{"name":"4 Gy in 2 fractions","n":315,"value":70.4,"note":"95% CI 64.7 to 75.4; 315 sites randomised"}],"hr":3.46,"ci":[2.25,5.33],"source":"https://doi.org/10.1016/S1470-2045(20)30686-0"},{"endpoint":"Local progression-free rate at 2 years in the irradiated site","unit":"%","arms":[{"name":"24 Gy in 12 fractions","n":299,"value":94.1,"note":"95% CI 90.6 to 96.4"},{"name":"4 Gy in 2 fractions","n":315,"value":79.8,"note":"95% CI 74.8 to 83.9"}],"source":"https://doi.org/10.1016/S1470-2045(20)30686-0"},{"endpoint":"Time to local progression, first analysis (hazard for 4 Gy against 24 Gy)","arms":[{"name":"4 Gy in 2 fractions","note":"70 local progressions"},{"name":"24 Gy in 12 fractions","note":"21 local progressions; median follow-up 26 months"}],"hr":3.42,"ci":[2.09,5.55],"source":"https://doi.org/10.1016/S1470-2045(14)70036-1"}]},"route":"/trials/fort/","neighbours":{"cancer":[{"id":"follicular-lymphoma","kind":"cancer","name":"Follicular lymphoma","route":"/cancers/follicular-lymphoma/"},{"id":"marginal-zone-lymphoma","kind":"cancer","name":"Marginal zone lymphoma","route":"/cancers/marginal-zone-lymphoma/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"}],"technology":[{"id":"hypofractionated-radiotherapy","kind":"technology","name":"Hypofractionated radiotherapy","route":"/technologies/hypofractionated-radiotherapy/"},{"id":"palliative-radiotherapy","kind":"technology","name":"Palliative radiotherapy","route":"/technologies/palliative-radiotherapy/"}],"institution":[{"id":"uclh","kind":"institution","name":"University College London Hospitals / UCL Cancer Institute","route":"/institutions/uclh/"}],"paper":[{"id":"paper-fort-long-term-follow-up-hoskin-lancet-oncol-2021","kind":"paper","name":"FoRT long-term follow-up: 4 Gy versus 24 Gy for follicular and marginal zone lymphoma","route":"/key-papers/paper-fort-long-term-follow-up-hoskin-lancet-oncol-2021/"},{"id":"paper-fort-4gy-vs-24gy-indolent-lymphoma-hoskin-lancet-oncol-2014","kind":"paper","name":"FoRT: 4 Gy versus 24 Gy radiotherapy for indolent lymphoma, a randomised phase 3 non-inferiority trial","route":"/key-papers/paper-fort-4gy-vs-24gy-indolent-lymphoma-hoskin-lancet-oncol-2014/"}]}}