title: Moderate hypofractionated radiotherapy is more effective and safe for localized prostate cancer patients: a meta-analysis.
abstract: To compare the efficacy and safety of moderate hypofractionated radiotherapy (H-RT) with those of conventional radiotherapy (C-RT) in patients with localized prostate cancer, we conducted extensive literature searches of The Web of Science, Embase, Pubmed and Cochrane Library databases. We identified nine studies with 5969 patients for a meta-analysis. We calculated pooled risk ratios (RRs) and the 95% confidence intervals (CIs) for multiple parameters and performed statistical analysis using RevMan 5.3 software. Our analysis showed that the H-RT group obtained greater improvements in the 5-year biochemical or clinical failure-free survival (RR = 1.04, 95% CI:1.01-1.08; P = 0.01) and 5-year disease-free survival(RR = 1.04, 95% CI: 1.01-1.07, P = 0.02) than the C-RT group. However, the 5-year overall survival rates were comparable in the two groups (RR = 1.02, 95% CI: 0.99-1.04; P = 0.18). Comparison of multiple secondary parameters, including grade 2-4 acute/late gastrointestinal toxicity, grade 2-4 acute/late genitourinary toxicity, biochemical failure, local failure, distant failure and prostate cancer-specific mortality between the H-RT and the C-RT groups showed no statistical differences. This meta-analysis thus indicates that in patients with localized prostate cancer, moderate H-RT exerts a great beneficial effect on the primary parameters than C-RT without enhancing adverse events.
authors.affiliation: Department of Radiation Oncology, Cancer Hospital of Jilin Province, Changchun 130012, People's Republic of China.
authors.forename: Ling
authors.initials: L
authors.lastname: Cao
authors.affiliation: Department of Radiation Oncology, Cancer Hospital of Jilin Province, Changchun 130012, People's Republic of China.
authors.forename: Yong-Jing
authors.initials: YJ
authors.lastname: Yang
authors.affiliation: Department of Anesthesiology, The First Hospital Affiliated to Jilin University, Changchun 130012, People's Republic of China.
authors.forename: Zhi-Wen
authors.initials: ZW
authors.lastname: Li
authors.affiliation: Department of Radiation Oncology, Cancer Hospital of Jilin Province, Changchun 130012, People's Republic of China.
authors.forename: Hong-Fen
authors.initials: HF
authors.lastname: Wu
authors.affiliation: Department of Radiation Oncology, Cancer Hospital of Jilin Province, Changchun 130012, People's Republic of China.
authors.forename: Zhu-Chun
authors.initials: ZC
authors.lastname: Yang
authors.affiliation: Department of Radiation Oncology, Cancer Hospital of Jilin Province, Changchun 130012, People's Republic of China.
authors.forename: Shi-Xin
authors.initials: SX
authors.lastname: Liu
authors.affiliation: Department of Radiotherapy, Cancer Institute and Hospital of Tianjin Medical University, Tianjin 300060, People's Republic of China.
authors.forename: Ping
authors.initials: P
authors.lastname: Wang
mesh_terms: D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016017:Odds Ratio; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D000069473:Radiation Dose Hypofractionation; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D016019:Survival Analysis; D017211:Treatment Failure; D016896:Treatment Outcome
keywords: hypofractionation; meta-analysis; prostatic neoplasms; radiotherapy