Moderate hypofractionated radiotherapy is more effective and safe for localized prostate cancer patients: a meta-analysis

// Ling Cao 1 , Yong-Jing Yang 1 , Zhi-Wen Li 2 , Hong-Fen Wu 1 , Zhu-Chun Yang 1 , Shi-Xin Liu 1 , Ping Wang 3 1 Department of Radiation Oncology, Cancer Hospital of Jilin Province, Changchun 130012, People’s Republic of China 2 Department of Anesthesiology, The First Hospital Affiliated to Jilin University, Changchun 130012, People’s Republic of China 3 Department of Radiotherapy, Cancer Institute and Hospital of Tianjin Medical University, Tianjin 300060, People’s Republic of China Correspondence to: Shi-Xin Liu, email: liushixin1964@sina.com Ping Wang, email: wangping.99999@yahoo.com.cn Keywords: prostatic neoplasms, hypofractionation, radiotherapy, meta-analysis Received: August 08, 2016 Accepted: November 24, 2016 Published: December 01, 2016 ABSTRACT To compare the efficacy and safety of moderate hypofractionated radiotherapy (H-RT) with those of conventional radiotherapy (C-RT) in patients with localized prostate cancer, we conducted extensive literature searches of The Web of Science, Embase, Pubmed and Cochrane Library databases. We identified nine studies with 5969 patients for a meta-analysis. We calculated pooled risk ratios (RRs) and the 95% confidence intervals (CIs) for multiple parameters and performed statistical analysis using RevMan 5.3 software. Our analysis showed that the H-RT group obtained greater improvements in the 5-year biochemical or clinical failure-free survival (RR = 1.04, 95% CI:1.01–1.08; P = 0.01) and 5-year disease-free survival(RR = 1.04, 95% CI: 1.01–1.07, P = 0.02) than the C-RT group. However, the 5-year overall survival rates were comparable in the two groups (RR = 1.02, 95% CI: 0.99–1.04; P = 0.18). Comparison of multiple secondary parameters, including grade 2-4 acute/late gastrointestinal toxicity, grade 2–4 acute/late genitourinary toxicity, biochemical failure, local failure, distant failure and prostate cancer-specific mortality between the H-RT and the C-RT groups showed no statistical differences. This meta-analysis thus indicates that in patients with localized prostate cancer, moderate H-RT exerts a great beneficial effect on the primary parameters than C-RT without enhancing adverse events.