Efficacy and safety between brachytherapy combined with external beam radiation therapy and external beam radiation therapy alone for prostate cancer: a meta-analysis
10.3760/cma.j.issn.1004-4221.2019.07.007
- VernacularTitle:前列腺癌近距离照射联合外照射与单纯外照射疗效与安全性Meta分析
- Author:
Pengfei JIA
1
,
2
;
Xiaoxi ZHOU
;
Bin JI
;
Hui ZHAO
Author Information
1. 南通大学附属医院肿瘤放疗科 226001
2. 南通大学医学院 226001
- Keywords:
Prostate neoplasm/brachytherapy;
Prostate neoplasm/radiotherapy;
Treatment outcome;
Meta-analysis
- From:
Chinese Journal of Radiation Oncology
2019;28(7):509-513
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the efficacy and safety of brachytherapy (BT) combined with external beam radiation therapy (EBRT) and EBRT alone for prostate cancer.Methods Databases including PubMed,Web of Science,Cochrane Library,CNKI,WanFang Data and VIP were searched from the inception to July 2018 to collect the clinical trials which comparatively analyzed the efficacy and safety between EBRT plus BT and EBRT alone for prostate cancer.According to the inclusion and exclusion criteria,data of the included studies were extracted and the methodological quality was evaluated.Then,a meta-analysis was performed using RevMan 5.3.Results Ten studies of 23 393 patients were included,in which 6 were randomized controlled trials (RCTs) and the other 4 were non-RCTs.The 3-year biochemical progression-free survival (b-PFS)[OR=2.03(95％CI:1.11 to 3.73),P=0.02] and the 5-year b-PFS of intermediate-risk patients[OR=2.27(95％CI:1.49 to 3.45),P＜0.01] in the EBRT+BT group were significantly higher compared with those in the EBRT group.The 3-and 5-year b-PFS,5-year overall survival and 5-year metastasis-free survival did not differ between two groups.in the incidence of ≥ grade 2 acute[OR=1.44(95％CI:1.11 to 1.38),P＜0.01] and chronic genitourinary adverse reactions [OR=3.06(95％CI:1.37 to 6.80),P＜0.01],≥ grade 3 acute[OR=1.75 (95％CI:1.14 to 2.69),P=0.01] and chronic genitourinary adverse reactions[OR=3.41(95％CI:2.42 to 4.82),P＜0.01] in the EBRT group were significantly lower than those in the EBRT+BT group.The incidence of gastrointestinal adverse reactions did not significantly differ between two groups.Conclusion Compared with EBRT alone,EBRT combined with BT can effectively improve the 3-and 5-year b-PFS,whereas increase the incidence of genitourinary adverse reactions for patients with intermediate-risk prostate cancer.
