HDR brachytherapy as monotherapy for prostate cancer: A systematic review with meta-analysis
Autor: | Ligia Issa De Fendi, Caio Viani Arruda, Gustavo Arruda Viani, Antonio Cassio Assis Pellizzon |
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Přispěvatelé: | Universidade de São Paulo (USP), Universidade Estadual Paulista (Unesp), AC Camargo Cancer Center |
Rok vydání: | 2021 |
Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Brachytherapy Urology Effective dose (radiation) 030218 nuclear medicine & medical imaging law.invention Androgen deprivation therapy 03 medical and health sciences Prostate cancer 0302 clinical medicine Randomized controlled trial law medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Retrospective Studies business.industry Prostatic Neoplasms Androgen Antagonists Radiotherapy Dosage Retrospective cohort study Prostate-Specific Antigen medicine.disease Confidence interval Biochemical control Meta-analysis Oncology 030220 oncology & carcinogenesis business |
Zdroj: | Scopus Repositório Institucional da UNESP Universidade Estadual Paulista (UNESP) instacron:UNESP |
ISSN: | 1538-4721 |
DOI: | 10.1016/j.brachy.2020.10.009 |
Popis: | Made available in DSpace on 2021-06-25T10:20:38Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-03-01 Purpose: The effectiveness and safety of high dose brachytherapy as monotherapy (HDR-BRT-M) in prostate cancer is limited to retrospective studies. We performed a meta-analysis to summarize existing data and identify trends in biochemical recurrence-free survival (bRFS) and toxicity after HDR-BRT-M in patients with prostate cancer. Methods and Materials: Retrospective, prospective, or randomized clinical trials were identified on electronical databases through June 2020. We followed the PRISMA and MOOSE guidelines. A meta-regression analysis was performed to assess if there is a relationship between moderator variables and bRFS. A p-value < 0.05 was considered significant. Results: Fourteen studies with a total of 3534 patients treated were included. The cumulative size of the bRFS at 5 years was 0.92 (95% confidence interval (CI) 0.48–0.61). The five-year bRFS for low, intermediate, and high risk was 97.5% (95% CI 96–98%), 93.5% (95% CI 91–96%), and 91% (95% CI 88–93%), respectively. The total biological effective dose (BED) (p = 0.02), the BED per fraction (p = 0.001), androgen deprivation therapy usage (p = 0.04), and the number of fractions of HDR-BRT-M (p = 0.024) were significantly associated with bRFS rate. The rate of late Grade 2/3 or > genitourinary and gastrointestinal toxicity was 22.4% (95% CI 9–35,2%)/1.4% (95% CI 0.8–2.1%) and 2.7% (95% CI 0–6.8%) and 0.2% (95% CI 0.1%–0.4%), respectively. Conclusions: HDR-BRT-M is safe with excellent rates of bRFS for all risk groups. The total BED, the BED per fraction, and number of fractions were the key factors associated with the biochemical control. These data can be useful to choose the size and number of BRT fractionation. Ribeirão Medical School University of São Paulo Bioscience Institute of University of State from Sao Paulo (UNESP) Radiation Oncology Department AC Camargo Cancer Center Bioscience Institute of University of State from Sao Paulo (UNESP) |
Databáze: | OpenAIRE |
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