Aim: to evaluate efficacy and late toxicity of moderate hypofractionated (HFRT) over high-dose (>76 Gy) conventional radiotherapy (CRT) in a non-inferiority perspective. Methods: Randomized controlled trials (RCTs) were included. HFRT regimens were deemed non-inferior to high-dose CRT if the computed CI for the overall RR did not exceed the non-inferiority margin of 7%. Results: When the prespecified margin, corresponding to a critical RR of 0.930 for CCS, OS and BFS, was used all efficacy outcomes satisfied the criteria for the non-inferiority analysis indicating the non-inferiority of HFRT regimens over high-dose CRT in the medium term period. Differently, the evidence concerning the late toxicity was inconclusive. Conclusions: Noninferiority analysis indicates that moderate HFRT regimes are non-inferior over high-dose CRT in the medium-term. Inconclusive is the evidence for the late toxicity. Longer follow-up will provide a more clear answer concerning the non-inferiority of HFRT regimens in the long-term period.

Are we ready for a paradigm shift from high-dose conventional to moderate hypofractionated radiotherapy in intermediate-high risk prostate cancer? A systematic review of randomized controlled trials with trial sequential analysis / Ferella, L.; Limoncin, E.; Vittorini, F.; Chalaszczyk, A.; Sorce, C.; Grimaldi, G.; Franzese, P.; Ruggieri, V.; Varrassi, E.; Di Staso, M.; Gimenez De Lorenzo, R.; Marampon, F.; Tombolini, V.; Masciocchi, C.; Gravina, G. L.. - In: CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY. - ISSN 1040-8428. - 139:(2019), pp. 75-82. [10.1016/j.critrevonc.2019.04.012]

Are we ready for a paradigm shift from high-dose conventional to moderate hypofractionated radiotherapy in intermediate-high risk prostate cancer? A systematic review of randomized controlled trials with trial sequential analysis

Grimaldi G.;Marampon F.;Tombolini V.;
2019

Abstract

Aim: to evaluate efficacy and late toxicity of moderate hypofractionated (HFRT) over high-dose (>76 Gy) conventional radiotherapy (CRT) in a non-inferiority perspective. Methods: Randomized controlled trials (RCTs) were included. HFRT regimens were deemed non-inferior to high-dose CRT if the computed CI for the overall RR did not exceed the non-inferiority margin of 7%. Results: When the prespecified margin, corresponding to a critical RR of 0.930 for CCS, OS and BFS, was used all efficacy outcomes satisfied the criteria for the non-inferiority analysis indicating the non-inferiority of HFRT regimens over high-dose CRT in the medium term period. Differently, the evidence concerning the late toxicity was inconclusive. Conclusions: Noninferiority analysis indicates that moderate HFRT regimes are non-inferior over high-dose CRT in the medium-term. Inconclusive is the evidence for the late toxicity. Longer follow-up will provide a more clear answer concerning the non-inferiority of HFRT regimens in the long-term period.
hypofractionated radiotherapy; metanalysis; non-inferiority; prostate cancer; systematic review; humans; male; prostatic neoplasms; radiation dose hypofractionation; randomized controlled trials as topic; treatment outcome
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Are we ready for a paradigm shift from high-dose conventional to moderate hypofractionated radiotherapy in intermediate-high risk prostate cancer? A systematic review of randomized controlled trials with trial sequential analysis / Ferella, L.; Limoncin, E.; Vittorini, F.; Chalaszczyk, A.; Sorce, C.; Grimaldi, G.; Franzese, P.; Ruggieri, V.; Varrassi, E.; Di Staso, M.; Gimenez De Lorenzo, R.; Marampon, F.; Tombolini, V.; Masciocchi, C.; Gravina, G. L.. - In: CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY. - ISSN 1040-8428. - 139:(2019), pp. 75-82. [10.1016/j.critrevonc.2019.04.012]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1361391
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