Efficacy of three-dimensional conformal radiotherapy in treatment of prostate cancer:a meta-analysis / 中华放射肿瘤学杂志

ABSTRACT

Objective To systematically compare the efficacy of three-dimensional conformal radiotherapy (3D-CRT) versus intensity-modulated radiotherapy (IMRT) in the treatment of prostate cancer (PCa).Methods Clinical comparative studies of IMRT and 3D-CRT in the treatment of PCa were collected from PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), and Wanfang Data after two independent researchers developed the strategy and inclusion and exclusion criteria for the literature search.Articles published up to February 2017 were searched for, and the languages of publications were restricted to English and Chinese.Clinical meta-analysis of the data from the relevant studies was performed using the RevMan5.3 software.Results A total of 15 relevant retrospective cohort studies were collected from the databases in strict accordance to the search strategy and inclusion and excluding criteria.There were 4608 PCa patients, including 2229 in the IMRT group and 2379 in the 3D-CRT group.IMRT and 3D-CRT had similar adverse effects in terms of early-stage (odds ratio[OR]=0.77, 95% confidence interval[CI]0.43-1.40, P=0.390) and late-stage (OR=0.75, 95%CI0.55-1.04, P=0.080) urinary tract injury.However, IMRT led to reduced early-stage (OR=0.47, 95%CI0.27-0.82, P=0.008) and late-stage (OR=0.52, 95%CI0.35-0.78, P=0.001) intestinal injury compared with 3D-CRT.Meanwhile, the biochemical recurrence-free survival rate was also significantly higher in the IMRT group than in the 3D-CRT group (OR=1.87, 95%CI1.51-2.32, P=0.000).Conclusions IMRT is more protective against intestinal injury with a higher biochemical recurrence-free survival rate compared with 3D-CRT during the treatment of PCa.