Subscribe to RSS
DOI: 10.1055/s-0044-1797385
MODERATE HYPOFRACTIONATION SCHEDULE VERSUS CONVENTIONAL RADIOTHERAPY FOR PROSTATE CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS
Purpose: To evaluate if moderate hypofractionated radiotherapy schedule (MHYPORT) produces similar biochemical failure (BF), acute and late toxicity rates than conventional radiotherapy schedule (CONV-RT) for prostate cancer. Methods: A systematic review and meta-analysis were conducted including randomized clinical trials (RCT) comparing MHYPO-RT with CON-V-RT. The searches were performed on the electronic sources: MEDLINE, COCHRANE, LILACS, and EMBASE. A subgroup analysis of trials that used image-guided radiotherapy (IGRT) combined with intensity modulated radiotherapy (IMRT) and trials with MHYPO-RT schedules with equivalent dose in 2-Gy fractions (EQD2) > 76 Gy or both were performed. Results: The searches found 11 RCTs with 9318 patients comparing MHYPO-RT versus CONV-RT. BF occurred in 785/ 4676 (16.7%) patients in the HYPO-RT trials compared with 826/ 4642 (17.7%) in the CONV-RT, resulting in a OR = 0.93, 95%CI 0.83 - 1.04, p=0.2. The subgroup analysis showed a better BF rate for MHYPO-RT schedule for trials with EQD2 > 76 (p=0.002). MHYPO-RT was associated with a slight, but, a significant difference in acute GI/GU toxicity grade>=2 in trials with no use of IGRT/IMRT. A slight increased in the late GI/GU toxicity grade>= 2 was also seen with HYPO-RT vs. CONV-RT (GI/GU toxicity difference < 2.5%). In the subgroup analysis, no difference for late GI/GU toxicity grade>=2 was observed with IGRT/IMRT comparing MHYPO-RT and CONV-RT even with EQD2>76 Gy. Conclusion: MHYPO-RT with EQD2> 76 Gy resulted in better BF than CONV-RT. MHYPO-RT with EQD2> 76 Gy produced a slight increase in the acute/late GI/GU toxicity grade>=2. However, this slight difference in acute/ late GI/GU toxicity between MHYPO-RT and CONV-RT disappeared in trials using IGRT/IMRT even with EQD2>76 Gy.
No conflict of interest has been declared by the author(s).
Contato:
Publication History
Article published online:
10 July 2025
© 2017. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil