Abdominal Tumor
Efficacy and adverse effects of hypofractionated radiotherapy versus conventionally fractionated radiotherapy in patients with intermediate-to high-risk localized prostate cancer: a meta-analysis
Wei Guo, Xiaobin Gu, Xin Qi, Xianshu Gao, Mingwei Ma, Ming Cui, Mu Xie, Yun Bai, Chuan Peng
Published 2017-05-15
Cite as Chin J Radiat Oncol, 2017, 26(5): 542-545. DOI: 10.3760/cma.j.issn.1004-4221.2017.05.013
Abstract
ObjectiveTo compare the efficacy and adverse effects of hypofractionated radiotherapy versus conventionally fractionated radiotherapy for intermediate-to high-risk localized prostate cancer .
MethodsA literature search was performed in PubMed, Embase, Web of Science, CNKI, VIP database, and Wanfang Data to collect the controlled clinical trials of hypofractionated radiotherapy versus conventionally fractionated radiotherapy in patients with intermediate-to high-risk localized PCa published up to August 31, 2016. Stata 12.0 was used for meta-analysis. The difference between two groups was estimated by calculating the hazard ratio (HR) or risk ratio (RR) with 95% confidence interval (CI).
ResultsAccording to the inclusion and exclusion criteria, a total of 5 controlled clinical trials involving 1621 patients with PCa were included in this meta-analysis. The meta-analysis showed that overall survival (HR=1.00, 95%CI: 0.85-1.17, P=0.980) and biochemical failure (RR=0.87, 95%CI: 0.68-1.12, P=0.274) were comparable between the two groups. Compared with the conventionally fractionated radiotherapy, the incidence of acute gastrointestinal adverse events (grade≥2) was significantly higher in the hypofractionated radiotherapy (RR=1.94, 95%CI: 1.23-3.06, P=0.004). However, there were no significant differences in the incidence of acute genitourinary adverse events (grade≥2)(RR=1.03, 95%CI: 0.92-1.14, P=0.626), late gastrointestinal adverse events (grade≥2)(RR=1.17, 95%CI: 0.90-1.51, P=0.238), and late genitourinary adverse events (grade≥2)(RR=1.11, 95%CI: 0.94-1.30, P=0.228) between the two groups.
ConclusionsConventionally fractionated radiotherapy and hypofractionated radiotherapy have comparable therapeutic effects in patients with intermediate-to high-risk localized PCa. Although the patients treated with hypofractionated radiotherapy have a higher incidence of acute gastrointestinal adverse events than those treated with conventionally fractionated radiotherapy, the incidence of late gastrointestinal and genitourinary adverse events is comparable between the two groups of patients and the adverse effects are tolerable.
Key words:
Prostate neoplasms/radiotherapy; Radiotherapy, hypofractionated; Radiotherapy, conventional; Meta-analysis
Contributor Information
Wei Guo
Hebei North University, Zhangjiakou 075000, China
Xiaobin Gu
Department of Radiation Oncology, First Hospital, Peking University, Beijing 100034, China
Xin Qi
Department of Radiation Oncology, First Hospital, Peking University, Beijing 100034, China
Xianshu Gao
Department of Radiation Oncology, First Hospital, Peking University, Beijing 100034, China
Mingwei Ma
Department of Radiation Oncology, First Hospital, Peking University, Beijing 100034, China
Ming Cui
Department of Radiation Oncology, First Hospital, Peking University, Beijing 100034, China
Mu Xie
Department of Radiation Oncology, First Hospital, Peking University, Beijing 100034, China
Yun Bai
Department of Radiation Oncology, First Hospital, Peking University, Beijing 100034, China
Chuan Peng
Department of Radiation Oncology, First Hospital, Peking University, Beijing 100034, China
