PURPOSE: We sought to determine the optimal hypofractionated regimens of moderately hypofractionated (HFRT) versus conventionally fractionated (CFRT) external beam radiotherapy for localized prostate cancer (LPCA), having as primary endpoints the 5-year biochemical failure (BF) and late gastrointestinal (GI) and genitourinary (GU) toxicity. METHODS AND MATERIALS: We performed a systematic literature review of the Medline and National Library of Medicine databases according to the PRISMA guidelines. Only phase III trials of CFRT versus moderate HFRT for LPCa, reporting 5-year BF and/or minimum 3-year late ≥G2 toxicity rates were considered. RESULTS: A total of 11 manuscripts reporting the outcomes of 8145 patients gathered from 9 randomized trials met the eligibility criteria. No significant difference between CFRT and HFRT was found in any of the investigated outcome measures. 80%, 15% and 29% isolevel curves for freedom from BF (FFBF), GI and GU toxicity, respectively, resulting from grouping the median values of all endpoints, were calculated as a function of both total dose (Dtot) and dose per fraction (d). Trials using fractionation schedules (d × n) lying above the FFBF and below toxicity isolevels are expected to produce the best therapeutic ratio. CONCLUSIONS: Our analysis indicates an optimal therapeutic window within which Dtot, d and n can be safely adjusted. Owing to both the risks of uncertainty due to inclusion of trials with d up to 3.5 Gy, and the exploitation of different cell killing mechanisms associated to larger d, the extrapolation to extremely hypo-fractionated regimens is not warranted
Arcangeli, G., Arcangeli, S., Pinzi, V., Benassi, M., Benassi, M., & Strigari, L. (2018). Optimal scheduling of hypofractionated radiotherapy for localized prostate cancer: A systematic review and metanalysis of randomized clinical trials. CANCER TREATMENT REVIEWS, Nov(70), 22-29 [10.1016/j.ctrv.2018.07.003].
Citazione: | Arcangeli, G., Arcangeli, S., Pinzi, V., Benassi, M., Benassi, M., & Strigari, L. (2018). Optimal scheduling of hypofractionated radiotherapy for localized prostate cancer: A systematic review and metanalysis of randomized clinical trials. CANCER TREATMENT REVIEWS, Nov(70), 22-29 [10.1016/j.ctrv.2018.07.003]. | |
Tipo: | Articolo in rivista - Articolo scientifico | |
Carattere della pubblicazione: | Scientifica | |
Presenza di un coautore afferente ad Istituzioni straniere: | No | |
Titolo: | Optimal scheduling of hypofractionated radiotherapy for localized prostate cancer: A systematic review and metanalysis of randomized clinical trials | |
Autori: | Arcangeli, G; Arcangeli, S; Pinzi, V; Benassi, M; Benassi, M; Strigari, L | |
Autori: | ||
Data di pubblicazione: | 2018 | |
Lingua: | English | |
Rivista: | CANCER TREATMENT REVIEWS | |
Digital Object Identifier (DOI): | http://dx.doi.org/10.1016/j.ctrv.2018.07.003 | |
Appare nelle tipologie: | 01 - Articolo su rivista |
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