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Cited by 469Prostate Cancer Diagnosis and TreatmentAdvanced Radiotherapy TechniquesBreast Cancer Treatment Studies

Higher-than-conventional radiation doses in localized prostate cancer treatment: a meta-analysis of randomized, controlled trials

Viani, Gustavo Arruda, Stefano, Eduardo Jose, Afonso, Sergio Luis·2009·International Journal of Radiation Oncology*Biology*Physics
DOI 10.1016/j.ijrobp.2008.10.091
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Abstract

Purpose To determine in a meta-analysis whether the outcomes in men with localized prostate cancer treated with high-dose radiotherapy (HDRT) are better than those in men treated with conventional-dose radiotherapy (CDRT), by quantifying the effect of the total dose of radiotherapy on biochemical control (BC).Methods and materials The MEDLINE, EMBASE, CANCERLIT, and Cochrane Library databases, as well as the proceedings of annual meetings, were systematically searched to identify randomized, controlled studies comparing HDRT with CDRT for localized prostate cancer. To evaluate the dose-response relationship, we conducted a meta-regression analysis of BC ratios by means of weighted linear regression.Results Seven RCTs with a total patient population of 2812 were identified that met the study criteria. Pooled results from these RCTs showed a significant reduction in the incidence of biochemical failure in those patients with prostate cancer treated with HDRT (p < 0.0001). However, there was no difference in the mortality rate (p = 0.38) and specific prostate cancer mortality rates (p = 0.45) between the groups receiving HDRT and CDRT. However, there were more cases of late Grade >2 gastrointestinal toxicity after HDRT than after CDRT. In the subgroup analysis, patients classified as being at low (p = 0.007), intermediate (p < 0.0001), and high risk (p < 0.0001) of biochemical failure all showed a benefit from HDRT. The meta-regression analysis also detected a linear correlation between the total dose of radiotherapy and biochemical failure (BC = -67.3 + [1.8 x radiotherapy total dose in Gy]; p = 0.04).Conclusions Our meta-analysis showed that HDRT is superior to CDRT in preventing biochemical failure in low-, intermediate-, and high-risk prostate cancer patients, suggesting that this should be offered as a treatment for all patients, regardless of their risk status.

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  • Advances in radiation oncology have improved outcomes in a number of different cancers.

    “This has resulted in improved outcomes in a number of different cancers (2, 342–350).”

    From Adrenocortical carcinoma (2014) · cites this paper as [2]

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Authors
Viani, G. A., Stefano, E. J., & Afonso, S. L.
Affiliations
Faculdade de Medicina de Marília (BR)
Corresponding author
Viani, Gustavo Arruda
ORCID
Viani, Gustavo Arruda
Venue
International Journal of Radiation Oncology*Biology*Physics
Publisher
Elsevier BV
Published
2009-08
Volume
74
Issue
5
Pages
1405-1418
ISSN
0360-3016 (ISSN-L)
DOI
10.1016/j.ijrobp.2008.10.091
OpenAlex
W2165244734
Cited by
469
References
33
Citations by year
2026: 5 · 2025: 7 · 2024: 9 · 2023: 14 · 2022: 27 · 2021: 22 · 2020: 22 · 2019: 32 · 2018: 31 · 2017: 35 · 2016: 35 · 2015: 40 · 2014: 45 · 2013: 55 · 2012: 37
FWCI
4.51
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • International Journal of Radiation Oncology*Biology*Physics (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Diagnosis and Treatment
  • Physical Sciences › Physics and Astronomy › Radiation › Advanced Radiotherapy Techniques
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
Keywords
localized prostate cancer, high-dose radiotherapy, biochemical recurrence, prostate cancer mortality, late gastrointestinal toxicity, risk stratification, radiotherapy toxicity
MeSH terms
Dose-Response Relationship, Radiation, Humans, Male, Prostatic Neoplasms, Regression Analysis, Survival Rate, Randomized Controlled Trials as Topic, Prostate-Specific Antigen

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