HDR brachytherapy as monotherapy for prostate cancer: A systematic review with meta-analysis
Autor(a) principal: | |
---|---|
Data de Publicação: | 2021 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1016/j.brachy.2020.10.009 http://hdl.handle.net/11449/205752 |
Resumo: | 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. |
id |
UNSP_6bd9a0c0d53ac9ff6723da19d173e7b5 |
---|---|
oai_identifier_str |
oai:repositorio.unesp.br:11449/205752 |
network_acronym_str |
UNSP |
network_name_str |
Repositório Institucional da UNESP |
repository_id_str |
2946 |
spelling |
HDR brachytherapy as monotherapy for prostate cancer: A systematic review with meta-analysisBiochemical controlBrachytherapyMeta-analysisProstate cancerPurpose: 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 PauloBioscience Institute of University of State from Sao Paulo (UNESP)Radiation Oncology Department AC Camargo Cancer CenterBioscience Institute of University of State from Sao Paulo (UNESP)Universidade de São Paulo (USP)Universidade Estadual Paulista (Unesp)AC Camargo Cancer CenterViani, Gustavo ArrudaArruda, Caio Viani [UNESP]Assis Pellizzon, Antonio CassioDe Fendi, Ligia Issa2021-06-25T10:20:38Z2021-06-25T10:20:38Z2021-03-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article307-314http://dx.doi.org/10.1016/j.brachy.2020.10.009Brachytherapy, v. 20, n. 2, p. 307-314, 2021.1873-14491538-4721http://hdl.handle.net/11449/20575210.1016/j.brachy.2020.10.0092-s2.0-85099551312Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengBrachytherapyinfo:eu-repo/semantics/openAccess2021-10-22T17:02:10Zoai:repositorio.unesp.br:11449/205752Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-05T15:22:06.088413Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
HDR brachytherapy as monotherapy for prostate cancer: A systematic review with meta-analysis |
title |
HDR brachytherapy as monotherapy for prostate cancer: A systematic review with meta-analysis |
spellingShingle |
HDR brachytherapy as monotherapy for prostate cancer: A systematic review with meta-analysis Viani, Gustavo Arruda Biochemical control Brachytherapy Meta-analysis Prostate cancer |
title_short |
HDR brachytherapy as monotherapy for prostate cancer: A systematic review with meta-analysis |
title_full |
HDR brachytherapy as monotherapy for prostate cancer: A systematic review with meta-analysis |
title_fullStr |
HDR brachytherapy as monotherapy for prostate cancer: A systematic review with meta-analysis |
title_full_unstemmed |
HDR brachytherapy as monotherapy for prostate cancer: A systematic review with meta-analysis |
title_sort |
HDR brachytherapy as monotherapy for prostate cancer: A systematic review with meta-analysis |
author |
Viani, Gustavo Arruda |
author_facet |
Viani, Gustavo Arruda Arruda, Caio Viani [UNESP] Assis Pellizzon, Antonio Cassio De Fendi, Ligia Issa |
author_role |
author |
author2 |
Arruda, Caio Viani [UNESP] Assis Pellizzon, Antonio Cassio De Fendi, Ligia Issa |
author2_role |
author author author |
dc.contributor.none.fl_str_mv |
Universidade de São Paulo (USP) Universidade Estadual Paulista (Unesp) AC Camargo Cancer Center |
dc.contributor.author.fl_str_mv |
Viani, Gustavo Arruda Arruda, Caio Viani [UNESP] Assis Pellizzon, Antonio Cassio De Fendi, Ligia Issa |
dc.subject.por.fl_str_mv |
Biochemical control Brachytherapy Meta-analysis Prostate cancer |
topic |
Biochemical control Brachytherapy Meta-analysis Prostate cancer |
description |
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. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-06-25T10:20:38Z 2021-06-25T10:20:38Z 2021-03-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1016/j.brachy.2020.10.009 Brachytherapy, v. 20, n. 2, p. 307-314, 2021. 1873-1449 1538-4721 http://hdl.handle.net/11449/205752 10.1016/j.brachy.2020.10.009 2-s2.0-85099551312 |
url |
http://dx.doi.org/10.1016/j.brachy.2020.10.009 http://hdl.handle.net/11449/205752 |
identifier_str_mv |
Brachytherapy, v. 20, n. 2, p. 307-314, 2021. 1873-1449 1538-4721 10.1016/j.brachy.2020.10.009 2-s2.0-85099551312 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Brachytherapy |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
307-314 |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
_version_ |
1808128502869786624 |