ASTRO Guideline on Hypofractionated Radiation Therapy for Localized Prostate Cancer
Published: Web posted: October 2026
This guideline provides evidence-based recommendations on the use of hypofractionated external beam radiation therapy (EBRT) in patients with localized prostate cancer, including indications for moderate hypofractionation (MHF) and ultrahypofractionation (UHF), appropriate dose-fractionation regimens, target volumes, and treatment planning and delivery techniques. It applies to patients with localized (N0M0) prostate cancer receiving EBRT as primary local therapy. This includes patients with low-risk prostate cancer who have declined active surveillance and those patients with intermediate-, high-, and very high-risk localized prostate cancer who have chosen EBRT as their primary local treatment modality. This guideline replaces ASTRO's original 2018 guideline on hypofractionation for localized prostate cancer.
Developed in collaboration with:
- American Society of Clinical Oncology
- American Urological Association
- European Society for Radiotherapy and Oncology
- Society of Urologic Oncology
- American Urological Association
- European Society for Radiotherapy and Oncology
- The Royal Australian and New Zealand College of Radiologists
- Society of Urologic Oncology
- Guideline slide set - coming soon
- Press release
