Efficacy and safety of high-dose versus conventional-dose conventionally fractionated external beam radiotherapy for stage T1b-4N0-1M0 prostate cancer: a meta-analysis
10.3760/cma.j.issn.1004-4221.2019.07.008
- VernacularTitle:T1b-4N0-1M0期前列腺癌高剂量及常规剂量放疗疗效及安全性对比Meta分析
- Author:
Hui WANG
1
,
2
;
Ruilin XIE
;
Qingwei QIN
;
Na LI
;
Sheng WANG
;
Xue ZHAO
;
Zhaohui QIN
;
Yuanhu YAO
Author Information
1. 徐州医科大学附属医院肿瘤放疗科 221002
2. 徐州医科大学研究生学院 221004
- Keywords:
Prostate neoplasm/radiotherapy;
Treatment outcome;
Meta-analysis
- From:
Chinese Journal of Radiation Oncology
2019;28(7):514-517
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the clinical efficacy and safety between high-dose (74 to 80 Gy) and conventional-dose (64.0 to 70.2 Gy) conventionally fractionated external beam radiotherapy for stage T1b-4No-1M0 prostate cancer in this meta-analysis.Methods A literature search was performed in PubMea,ambasa,aochrane Librara,aeb of Scienca,aBa,aanfang Data,aNKI and Chongqing VIP to collect clinical trials on high-dose versus conventional-dose conventionally fractionated external beam radiotherapy of prostate cancer from the inception to July 1,2018.The included literatures were evaluated by Cochrane quality evaluation criteria and subject to meta-analysis by using Review Manager 5.3 statistical software.Results A total of 7 randomized controlled clinical trials involving 4 132 patients were included in the meta-analysis.The meta-analysis showed that the high-dose and conventional-dose groups yielded similar 10-year overall survival (RR=1.01,95％CI:0.96 to 1.07,P=0.64) and 10-year prostate cancer-specific survival (RR=1.01,95％CI:0.98 to 1.03,P=0.47).The biochemical failure rate in the high-dose group was significantly lower than that in the conventional-dose group (RR =0.78,95％CI:0.70 to 0.86,P＜0.01).Compared with the conventional-dose groua,ahe incidence of late grade ≥ 2 gastrointestinal and genitourinary adverse reactions (RR=1.48,95％CI:1.31 to 1.67,P＜0.01;RR=1.35,95％CI:1.06 to 1.73,P=0.02) was significantly higher in the high-dose group.Conclusion High-dose conventionally fractionated external beam radiotherapy has advantages in reducing the biochemical failure rate of patients with stage T1b-4N0-1M0 prostate cancer.Nevertheless,whether it can improve overall survival and prostate cancer-specific survival remains to be validated.High-dose radiotherapy also induce a higher incidence rate of late grade ≥ 2 gastrointestinal and genitourinary adverse reactions compared with conventional-dose radiotherapy.
