title: Efficacy and toxicity of external-beam radiation therapy for localised prostate cancer: a network meta-analysis.
abstract: BACKGROUND
  Many radiation regimens for treating prostate cancer have been used over the years, but which regimen is optimal for localised or locally advanced prostate cancer lacks consensus. We performed a network meta-analysis to identify the optimal radiation regimen.
  
  
  METHODS
  We systematically reviewed data from 27 randomised controlled trials and could group seven radiation regimens as follows: low- and high-dose radiation therapy (LDRT and HDRT), LDRT+ short- or long-term androgen deprivation therapy (LDRT+SADT and LDRT+LADT), HDRT+SADT, hypofractionated radiotherapy (HFRT), and HFRT+SADT. The main outcomes were overall mortality (OM), prostate-specific antigen (PSA) failure, cancer-specific mortality, and adverse events.
  
  
  RESULTS
  For the network meta-analysis of 27 trials, LDRT+LADT and LDRT+SADT were associated with decreased risk of OM as compared with LDRT alone as was LDRT+LADT compared with HDRT. Apart from HFRT, all other treatments were associated with decreased risk of PSA failure as compared with LDRT. HFRT+SADT was associated with decreased risk of cancer-specific mortality as compared with HFRT, LDRT+SADT, HDRT, and LDRT.
  
  
  CONCLUSIONS
  HFRT+SADT therapy might be the most efficacious treatment but with worst toxicity for localised or locally advanced prostate cancer, and HDRT showed excellent efficacy but more adverse events.
authors.affiliation: Department of Public Health, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong 515041, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Department of Public Health, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong 515041, China.
authors.forename: J
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Public Health, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong 515041, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Public Health, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong 515041, China.
authors.forename: M
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
authors.forename: P
authors.initials: P
authors.lastname: Guo
authors.affiliation: Department of Public Health, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong 515041, China.
authors.forename: K
authors.initials: K
authors.lastname: Li
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D017430:Prostate-Specific Antigen
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