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Are we ready for a paradigm shift from high-dose conventional to moderate hypofractionated radiotherapy in intermediate-high risk prostate cancer? A systematic review of randomized controlled trials with trial sequential analysis

Ferella, Letizia ; Limoncin, Erika ; Vittorini, Francesca ; Chalaszczyk, Agnieszka ; Sorce, Claudia ; Grimaldi, Gianmarco ; Franzese, Pietro ; Ruggieri, Valeria ; Varrassi, Emilia ; Di Staso, Mario ; Gimenez De Lorenzo, Ramon ; Marampon, Francesco ; Tombolini, Vincenzo ; Masciocchi, Carlo ; Gravina, Giovanni Luca

Critical reviews in oncology/hematology, 2019-07, Vol.139, p.75-82 [Periódico revisado por pares]

Netherlands: Elsevier B.V

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  • Título:
    Are we ready for a paradigm shift from high-dose conventional to moderate hypofractionated radiotherapy in intermediate-high risk prostate cancer? A systematic review of randomized controlled trials with trial sequential analysis
  • Autor: Ferella, Letizia ; Limoncin, Erika ; Vittorini, Francesca ; Chalaszczyk, Agnieszka ; Sorce, Claudia ; Grimaldi, Gianmarco ; Franzese, Pietro ; Ruggieri, Valeria ; Varrassi, Emilia ; Di Staso, Mario ; Gimenez De Lorenzo, Ramon ; Marampon, Francesco ; Tombolini, Vincenzo ; Masciocchi, Carlo ; Gravina, Giovanni Luca
  • Assuntos: Hypofractionated radiotherapy ; Metanalysis ; Non-inferiority ; Prostate cancer ; Systematic review
  • É parte de: Critical reviews in oncology/hematology, 2019-07, Vol.139, p.75-82
  • Notas: ObjectType-Article-2
    SourceType-Scholarly Journals-1
    ObjectType-Undefined-1
    ObjectType-Feature-3
    content type line 23
  • Descrição: •Hypofractionated radiation regimes have been extensively explored in Pca.•Any evidence from systematic reviews on non-inferiority of HFRT vs high-dose CRT.•We provide evidence that HFRT is non-inferior over high-dose CRT in the medium-term.•Inconclusive is the evidence for the late toxicity. to evaluate efficacy and late toxicity of moderate hypofractionated (HFRT) over high-dose (>76 Gy) conventional radiotherapy (CRT) in a non-inferiority perspective. Randomized controlled trials (RCTs) were included. HFRT regimens were deemed non-inferior to high-dose CRT if the computed CI for the overall RR did not exceed the non-inferiority margin of 7%. When the prespecified margin, corresponding to a critical RR of 0.930 for CCS, OS and BFS, was used all efficacy outcomes satisfied the criteria for the non-inferiority analysis indicating the non-inferiority of HFRT regimens over high-dose CRT in the medium term period. Differently, the evidence concerning the late toxicity was inconclusive. Noninferiority analysis indicates that moderate HFRT regimes are non-inferior over high-dose CRT in the medium-term. Inconclusive is the evidence for the late toxicity. Longer follow-up will provide a more clear answer concerning the non-inferiority of HFRT regimens in the long-term period.
  • Editor: Netherlands: Elsevier B.V
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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