Intensity modulated radiation therapy (IMRT) can deliver higher doses with less damage of healthy tissues compared with three-dimensional radiation therapy (3DCRT). However, for the scenarios with better clinical outcomes for IMRT than 3DCRT in prostate cancer, the results remain ambiguous. We performed a meta-analysis to assess whether IMRT can provide better clinical outcomes in comparison with 3DCRT in patients diagnosed with prostate cancer.
We conducted a meta-analysis of 23 studies (n = 9556) comparing the clinical outcomes, including gastrointestinal (GI) toxicity, genitourinary (GU) toxicity, biochemical controland overall survival (OS).
IMRT was significantly associated with decreased 2-4 grade acute GI toxicity [risk ratio (RR) = 0.59 (95% confidence interval (CI), 0.44, 0.78)], late GI toxicity [RR = 0.54, 95%CI (0.38, 0.78)], late rectal bleeding [RR = 0.48, 95%CI (0.27, 0.85)], and achieved better biochemical control[RR = 1.17, 95%CI (1.08, 1.27)] in comparison with 3DCRT. IMRT and 3DCRT remain the same in regard of grade 2-4 acute rectal toxicity [RR = 1.03, 95%CI (0.45, 2.36)], late GU toxicity [RR = 1.03, 95%CI (0.82, 1.30)] and overall survival [RR = 1.07, 95%CI (0.96, 1.19)], while IMRT slightly increased the morbidity of grade 2-4 acute GU toxicity [RR = 1.08, 95%CI (1.00, 1.17)].
Although some bias cannot be ignored, IMRT appears to be a better choice for the treatment of prostate cancer when compared with 3DCRT.
PloS one. 2016 May 12*** epublish ***
Ting Yu, Qiongwen Zhang, Tianying Zheng, Huashan Shi, Yang Liu, Shijian Feng, Meiqin Hao, Lei Ye, Xueqian Wu, Cheng Yang
State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC., State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC., State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC., State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC., State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC., State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC., State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC., State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC., State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC., State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC.