Dose Response and Fractionation Sensitivity of Prostate Cancer After External Beam Radiation Therapy: A Meta-analysis of Randomized Trials

International Journal of Radiation Oncology, Biology, Physics
Ivan R Vogelius, Søren M Bentzen

Abstract

Randomized trials of altered dose/fractionation for external beam radiation therapy are meta-analyzed with the aim of establishing the dose response and fractionation sensitivity. Studies were identified through PubMed through April 1, 2017. Studies of any-risk prostate cancer patients and any modification of external beam radiation therapy were included. The outcomes and comparisons collected were hazard ratios for biochemical no evidence of disease (bNED) and overall survival (OS). Trial-by-trial estimates of the steepness of the dose-response curve for bNED were performed for dose-escalation trials, followed by inverse variance weighting. The steepness was used to extract estimates of α/β, which were subsequently synthesized. Both analyses were performed assuming no effect of overall treatment time and were repeated assuming a loss of 0.31 Gy/d for a protracted treatment time. Finally, all trials were included in the analyses of the dose response for fractionation-corrected doses. This analysis was repeated for OS. Finally, the per-trial effect on OS was compared to the effect on bNED. We identified 13 randomized trials involving 10,184 patients. The dose response for bNED from dose-escalation trials was γ50 = 0.62 (95% conf...Continue Reading

Citations

Feb 11, 2020·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·Stratos VassisRoland Merten
Mar 4, 2020·Acta Oncologica·Kerri BeckmannPär Stattin
Apr 8, 2020·Molecular Oncology·Ivan R VogeliusSøren M Bentzen
Aug 25, 2020·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·Jörg TamihardjaBülent Polat
Mar 20, 2019·Journal of Cancer Research and Clinical Oncology·Vérane AchardThomas Zilli
Jul 17, 2020·Frontiers in Oncology·Victor R Adorno FeblesDavid R Wise
Dec 11, 2020·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·Frank WolfThomas Wiegel
Oct 5, 2020·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Peter J HoskinGerry J Lowe
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Jan 21, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Linda G W KerkmeijerUulke A van der Heide
Nov 24, 2020·International Journal of Radiation Oncology, Biology, Physics·Nolan A WagesTimothy N Showalter
Jun 5, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Ivan R Vogelius, Søren M Bentzen
Jun 22, 2021·Medical Dosimetry : Official Journal of the American Association of Medical Dosimetrists·Finbar SlevinAnn M Henry
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Jul 31, 2020·Mini Reviews in Medicinal Chemistry·Zhi-Gang SunHai-Liang Zhu
Nov 15, 2021·International Journal of Radiation Oncology, Biology, Physics·Raquibul HannanRobert D Timmerman

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