Efficacy and toxicity of external-beam radiation therapy for localised prostate cancer: a network meta-analysis

Abstract

Background:Many radiation regimens for treating prostate cancer have been used over the years, but which regimen is optimal for localised or locally advanced prostate cancer lacks consensus. We performed a network meta-analysis to identify the optimal radiation regimen.Methods:We systematically reviewed data from 27 randomised controlled trials and could group seven radiation regimens as follows: low- and high-dose radiation therapy (LDRT and HDRT), LDRT+ short- or long-term androgen deprivation therapy (LDRT+SADT and LDRT+LADT), HDRT+SADT, hypofractionated radiotherapy (HFRT), and HFRT+SADT. The main outcomes were overall mortality (OM), prostate-specific antigen (PSA) failure, cancer-specific mortality, and adverse events.Results:For the network meta-analysis of 27 trials, LDRT+LADT and LDRT+SADT were associated with decreased risk of OM as compared with LDRT alone as was LDRT+LADT compared with HDRT. Apart from HFRT, all other treatments were associated with decreased risk of PSA failure as compared with LDRT. HFRT+SADT was associated with decreased risk of cancer-specific mortality as compared with HFRT, LDRT+SADT, HDRT, and LDRT.Conclusions:HFRT+SADT therapy might be the most efficacious treatment but with worst toxicity for localised or locally advanced prostate cancer, and HDRT showed excellent efficacy but more adverse events.

Vision and Relevant Risk Factor Interventions for Preventing Falls among Older People: A Network Meta-analysis

“…Non-informative priors were used throughout. We used the posterior mean of the residual deviance and deviance information criteria to assess the model’s goodness of fit 34 . A model is considered as a good fit when the residual deviance was close to the number of data points 35 .…”

“…A model is considered as a good fit when the residual deviance was close to the number of data points 35 . Moreover, we evaluated the probability that every intervention was best in terms of efficacy, and second, up to eighth best 34 . The OR was calculated when every intervention group made comparison with the control group.…”

Decision aids for localized prostate cancer treatment choice: Systematic review and meta‐analysis

“…[2][3][4][5] However, this survival benefit comes at the price of impaired urinary, sexual, and bowel-related quality of life. [6][7][8] The long natural history of prostate cancer also makes active surveillance a reasonable treatment approach, especially for patients with low-risk disease. [9][10][11][12][13] Similarly, watchful waiting may also be appropriate for patients who have low-risk to intermediate-risk disease and limited life expectancy.…”

Factor Analysis and Psychometric Properties Adaption of Chinese Version of the Decisional Engagement Scale (DES-10)

“… 3 Nowadays, alternative treatments are used in prostate cancer treatment, 4 such as watchful waiting, active surveillance, surgery, chemotherapy, etc. Surgery and chemotherapy could help certain patients survive the disease, while with side effects like impaired urinary function, 5 sexual dysfunction, 6 and lower quality of life. 7 Active surveillance might be a preferable choice for patients with low-risk disease, 8 and watchful waiting could help patients with intermediate-risk disease to achieve satisfactory quality of life.…”