Practical Guidelines on Implementing Hypofractionated Radiotherapy for Prostate Cancer in Africa

William Swanson*, Richard Ndi Samba, Michael Lavelle, Ahmed Elzawawy, Erno Sajo, Wilfred Ngwa, Luca Incrocci

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Web of Science)
37 Downloads (Pure)


Among a growing body of literature in global oncology, several articles project increased
cost savings and radiotherapy access by adopting hypofractionated radiotherapy (HFRT)
in low- and middle-income countries (LMICs) like those in Africa. Clinical trials in Europe
and the USA have demonstrated HFRT to be non-inferior to conventional radiotherapy for
eligible patients with several cancers, including prostate cancer. This could be a highly
recommended option to battle a severely large and growing cancer burden in resourcelimited regions. However, a level of implementation research may be needed in limited
resource-settings like in Africa. In this article, we present a list of evidence-based
recommendations to practice HFRT on eligible prostate cancer patients. As literature
on HFRT is still developing, these guidelines were compiled from review of several clinical
trials and professionally accredited material with minimal resource requirements in mind.
HFRT guidelines presented here include patient eligibility, prescription dose schedules,
treatment planning and delivery techniques, and quality assurance procedures. The article
provides recommendations for both moderately hypofractionated (2.4-3.4Gy per fraction)
and ultrahypofractionated (5Gy or more per fraction) radiation therapy when administered
by 3D-Conformal Radiotherapy, Intensity Modulated Radiation Therapy, or Image-Guided
Radiotherapy. In each case radiation oncology health professionals must make the
ultimate judgment to ensure safety as more LMIC centers adopt HFRT to combat the
growing scourge of cancer.
Original languageEnglish
Article number725103
JournalFrontiers in Oncology
Publication statusPublished - 1 Dec 2021

Bibliographical note

This work is partially supported by the Global Health Catalyst
funding and National Institutes of Health under Award Number
R01CA239042. The content is solely the responsibility of the
authors and does not necessarily represent the views of the
National Institutes of Health.


Dive into the research topics of 'Practical Guidelines on Implementing Hypofractionated Radiotherapy for Prostate Cancer in Africa'. Together they form a unique fingerprint.

Cite this