دورية أكاديمية

Adjuvant and Salvage Radiotherapy after Prostatectomy: A Systematic Review and Meta-Analysis.

التفاصيل البيبلوغرافية
العنوان: Adjuvant and Salvage Radiotherapy after Prostatectomy: A Systematic Review and Meta-Analysis.
المؤلفون: Chen, Changhao, Lin, Tianxin, Zhou, Yu, Li, Doudou, Xu, Kewei, Li, Zhihua, Fan, Xinxiang, Zhong, Guangzheng, He, Wang, Chen, Xu, He, Xianyin, Huang, Jian
المصدر: PLoS ONE; Aug2014, Vol. 9 Issue 8, p1-14, 14p
مصطلحات موضوعية: RADIOTHERAPY, PROSTATECTOMY, SYSTEMATIC reviews, META-analysis, SURGICAL excision, ADJUVANT treatment of cancer
مستخلص: Purpose: In men with adverse prognostic factors (APFs) after radical prostatectomy (RP), the most appropriate timing to administer radiotherapy remains a subject for debate. We conducted a systemic review and meta-analysis to evaluate the therapeutic strategies: adjuvant radiotherapy (ART) and salvage radiotherapy (SRT). Materials and Methods: We comprehensively searched PubMed, EMBASE, Web of Science and the Cochrane Library and performed the meta-analysis of all randomized controlled trials (RCTs) and retrospective comparative studies assessing the prognostic factors of ART and SRT. Results: Between May 1998 and July 2012, 2 matched control studies and 16 retrospective studies including a total of 2629 cases were identified (1404 cases for ART and 1185 cases for SRT). 5-year biochemical failure free survival (BFFS) for ART was longer than that for SRT (Hazard Ratio [HR]: 0.37; 95% CI, 0.30–0.46; p<0.00001, I2 = 0%). 3-year BFFS was significantly longer in the ART (HR: 0.38; 95% CI, 0.28–0.52; p<0.00001, I2 = 0%). Overall survival (OS) was also better in the ART (RR: 0.53; 95% CI, 0.41–0.68; p<0.00001, I2 = 0%), as did disease free survival (DFS) (RR: 0.53; 95% CI, 0.43–0.66; p<0.00001, I2 = 0%). Exploratory subgroup analysis and sensitivity analysis revealed the similar results with original analysis. Conclusion: ART therapy offers a safe and efficient alternative to SRT with longer 3-year and 5-year BFFS, better OS and DFS. Our recommendation is to suggest ART for patients with APFs and may reduce the need for SRT. Given the inherent limitations of the included studies, future well-designed RCTs are awaited to confirm and update this analysis. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Complementary Index
الوصف
تدمد:19326203
DOI:10.1371/journal.pone.0104918