{"entity":{"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","aka":[],"tldr":"Two small doses of radiotherapy did not control follicular and marginal zone lymphoma as well as the standard twelve, with more than three times the rate of regrowth in the treated area, so 24 Gy remains the standard and 4 Gy is for palliation.","summary":"UK phase 3 non-inferiority trial at 43 centres: 614 target sites in patients with follicular or marginal zone lymphoma were randomised to 24 Gy in 12 fractions (299 sites) or 4 Gy in 2 fractions (315 sites) between 2006 and 2011. The primary endpoint was time to local progression in the irradiated field.\n\nAfter a median follow-up of 26 months there were 21 local progressions after 24 Gy and 70 after 4 Gy; time to local progression with 4 Gy was not non-inferior (hazard ratio 3.42).","asOf":"2026-09-22","links":[{"label":"Lancet Oncol 2014","url":"https://doi.org/10.1016/S1470-2045(14)70036-1"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/24572077/"}],"tags":[],"related":[],"cancers":["follicular-lymphoma","marginal-zone-lymphoma"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["fort"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet-oncology"],"dependsOn":[],"notes":[],"journal":"The Lancet Oncology","year":2014,"doi":"10.1016/S1470-2045(14)70036-1","pmid":"24572077","authors":"Hoskin PJ, Kirkwood AA, Popova B, et al.","paperType":"rct","findings":["Local progressions 21 after 24 Gy versus 70 after 4 Gy at a median follow-up of 26 months.","Hazard ratio for local progression 3.42 (95% CI 2.09 to 5.55); 4 Gy not non-inferior."],"whatItMeans":"24 Gy in 12 fractions is the standard radiotherapy dose for indolent lymphoma when durable local control is the aim; 4 Gy remains useful for palliation.","caveats":["Randomisation was by site rather than patient; both curative and palliative intents were included."],"changedPractice":true,"participants":548},"route":"/key-papers/paper-fort-4gy-vs-24gy-indolent-lymphoma-hoskin-lancet-oncol-2014/","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/"}],"trial":[{"id":"fort","kind":"trial","name":"FoRT","route":"/trials/fort/"}],"journal":[{"id":"lancet-oncology","kind":"journal","name":"The Lancet Oncology","route":"/journals/lancet-oncology/"}]}}