A structured literature review to determine the use of the American Society for Therapeutic Radiology and Oncology consensus definition of biochemical failure.
OBJECTIVE
The American Society for Therapeutic Radiology and Oncology consensus definition (ACD) of biochemical failure after radiotherapy for prostate cancer requires three consecutive prostate-specific antigen increases from a nadir value. The members of the Consensus Panel recognized that the timing and frequency of prostate-specific antigen determinations could affect the comparability among different reports if this definition was used. For this reason, the Consensus Panel members recommended three guidelines for studies presented for publication (publication guidelines [PGs]). The present analysis examined the extent to which the ACD has been used in the peer-reviewed published literature and how frequently the PGs have been followed.


METHODS
A structured literature review of 10 relevant journals was done. The inclusion criteria for the literature review required publication in calendar year 1999 or 2000; treatment with external beam radiotherapy and/or brachytherapy for previously untreated, nonmetastatic prostate cancer; and the use of a prostate-specific antigen-defined disease-free endpoint. A standardized checklist was created and completed by both of the authors. We independently reviewed each publication to determine whether the ACD of biochemical failure was used and whether the PGs were followed. Discrepancies between us were resolved by joint review of each publication in question to achieve a consensus.


RESULTS
Fifty-seven articles met the inclusion criteria. The median number of patients in the articles reviewed was 302 (range 22 to 2222). The ACD was followed in 37 (64.9%) of 57 articles. None of the reviewed articles followed all three PGs. In five articles (8.7%), two of the three PGs were followed. The vast majority of the articles reviewed (52 of 57, 91.3%) followed one or none of the PGs recommended by the Consensus Panel.


CONCLUSIONS
The ACD was used in two thirds of peer-reviewed published articles. The PGs were followed much less frequently. Consistent standards of reporting have not been uniformly applied to peer-reviewed manuscripts.
McMullen
Kevin P
KP
Department of Radiation Oncology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA.
Lee
W Robert
WR
D001918:Brachytherapy; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D017712:Peer Review, Research / Q000592:standards*; D010506:Periodicals as Topic / Q000592:standards; D017410:Practice Guidelines as Topic / Q000592:standards; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000532:radiotherapy*; D018787:Radiation Oncology / Q000592:standards; D020266:Radiotherapy, Conformal; D015203:Reproducibility of Results; D012955:Societies, Medical / Q000592:standards; D016019:Survival Analysis; D009626:Terminology as Topic; D014481:United States
D017430:Prostate-Specific Antigen