We’re just too excited about this STAMPEDE for only one QuadShot. So let’s talk about the radiation in more detail. Both hypofractionation (55 Gy / 20 daily treatments) and extreme hypofractionation (36 Gy in 6 weekly treatments) were used with a near 50/50 split. Not only were there no major differences in toxicity +/- radiation, there we no major differences between radiation regimens. Grade 3+ toxicity was low: 5% bladder and 1% bowel. The use of both regimens was a great move on the part of the study designers in foreseeing all the haters who don’t wanna “put patients through” longer courses of radiation therapy. TBL: Extreme hypofractionation was used in half of patients randomized to radiation in STAMPEDE, which improved survival in men with low-burden metastatic prostate cancer. | Parker, Lancet 2018


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