title: Palliative pelvic radiotherapy of symptomatic incurable prostate cancer - a systematic review.
abstract: OBJECTIVE
  Patients with prostate cancer (PC) and a symptomatic pelvic tumor may be treated with palliative pelvic radiotherapy for symptom relief or to delay symptom progression. Radiotherapy dose and fractionation regimens vary. We aimed to provide an overview of the literature and to evaluate palliative pelvic radiotherapy of PC focusing on symptomatic effect, quality of life (QOL), and toxicity, and to determine the optimal radiotherapy schedule.
  
  
  METHODS
  Systematic literature searches of Medline, Embase and Cochrane databases were performed through 2011. Studies reporting symptom and QOL responses were eligible.
  
  
  RESULTS
  Nine studies were included, all retrospective chart reviews. There were large variations in radiotherapy dose and fractionation. Overall symptom response rate was 75% and positive responses were reported for hemorrhage (73%), pain (80%), bladder outlet obstruction (63%), rectal symptoms (78%) and ureteric obstruction (62%). Toxicity results were not evaluable.
  
  
  CONCLUSIONS
  Despite limitations in the review process and the included studies, we conclude that pelvic radiotherapy for symptomatic PC appears to provide effective palliation of a variety of symptoms. There is currently no valid documentation regarding onset or duration of palliation. No recommendations can be provided regarding target dose or fractionation schedule in this context.
authors.affiliation: Center for Cancer Treatment, Sørlandet Hospital Trust, Kristiansand, Norway. Electronic address: Marte.Cameron@sshf.no.
authors.forename: Marte Grønlie
authors.initials: MG
authors.lastname: Cameron
authors.affiliation: Center for Cancer Treatment, Sørlandet Hospital Trust, Kristiansand, Norway.
authors.forename: Christian
authors.initials: C
authors.lastname: Kersten
authors.affiliation: Department of Oncology, Oslo University Hospital, Norway.
authors.forename: Marianne Grønlie
authors.initials: MG
authors.lastname: Guren
authors.affiliation: Department of Oncology, Oslo University Hospital, Norway.
authors.forename: Sophie Dorothea
authors.initials: SD
authors.lastname: Fosså
authors.affiliation: Department of Obstetrics and Gynecology, Sørlandet Hospital Trust, Kristiansand, Norway.
authors.forename: Ingvild
authors.initials: I
authors.lastname: Vistad
mesh_terms: D019583:Dose Fractionation, Radiation; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000379:methods*; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011788:Quality of Life; D012189:Retrospective Studies
keywords: Palliative radiotherapy; Pelvic tumor; Prostate cancer; Quality of life; Symptoms; Toxicity