Evidence-based review of three-dimensional conformal radiotherapy for localized prostate cancer: an ASTRO outcomes initiative.
OBJECTIVE
To perform a systematic review of the evidence to determine the efficacy and effectiveness of three-dimensional conformal radiotherapy (3D-CRT) for localized prostate cancer; provide a clear presentation of the key clinical outcome questions related to the use of 3D-CRT in the treatment of localized prostate cancer that may be answered by a formal literature review; and provide concise information on whether 3D-CRT improves the clinical outcomes in the treatment of localized prostate cancer compared with conventional RT.


METHODS
We performed a systematic review of the literature through a structured process developed by the American Society for Therapeutic Radiology and Oncology's Outcomes Committee that involved the creation of a multidisciplinary task force, development of clinical outcome questions, a formal literature review and data abstraction, data review, and outside peer review.


RESULTS
Seven key clinical questions were identified. The results and task force conclusions of the literature review for each question are reported.


CONCLUSIONS
The technological goals of reducing morbidity with 3D-CRT have been achieved. Randomized trials and follow-up of completed trials remain necessary to address these clinical outcomes specifically with regard to patient subsets and the use of hormonal therapy.
Morris
David E
DE
Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC 27514, USA. morrisda@med.unc.edu
Emami
Bahman
B
Mauch
Peter M
PM
Konski
Andre A
AA
Tao
May L
ML
Ng
Andrea K
AK
Klein
Eric A
EA
Mohideen
Najeeb
N
Hurwitz
Mark D
MD
Fraas
Bendick A
BA
Roach
Mack
M
Gore
Elizabeth M
EM
Tepper
Joel E
JE
D018572:Disease-Free Survival; D019317:Evidence-Based Medicine; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000517:prevention & control; D018787:Radiation Oncology; D020266:Radiotherapy, Conformal / Q000379:methods*; D016896:Treatment Outcome