Systematic review of hypofractionated radiation therapy for prostate cancer
Abstract Prostate cancer is the second most prevalent solid tumor diagnosed in men in the United States and Western Europe. Conventionally fractionated external beam radiation therapy (1.8–2.0 Gy/fraction) is an established treatment modality for men in all disease risk groups. Emerging evidence fro...
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| Veröffentlicht in: | Cancer treatment reviews 2013-11, Vol.39 (7), p.728-736 |
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| creator | Zaorsky, Nicholas G Ohri, Nitin Showalter, Timothy N Dicker, Adam P Den, Robert B |
| description | Abstract Prostate cancer is the second most prevalent solid tumor diagnosed in men in the United States and Western Europe. Conventionally fractionated external beam radiation therapy (1.8–2.0 Gy/fraction) is an established treatment modality for men in all disease risk groups. Emerging evidence from experimental and clinical studies suggests that the α / β ratio for prostate cancer may be as low as 1.5 Gy, which has prompted investigators around the world to explore moderately hypofractionated radiation therapy (2.1–3.5 Gy/fraction). We review the impetus behind moderate hypofractionation and the current clinical evidence supporting moderate hypofractionated radiation therapy for prostate cancer. Although hypofractionated radiation therapy has many theoretical advantages, there is no clear evidence from prospective, randomized, controlled trials showing that hypofractionated schedules have improved outcomes or lower toxicity than conventionally fractionated regimens. Currently, hypofractionated schedules should only be used in the context of clinical trials. High dose rate brachytherapy and stereotactic body radiation therapy (fraction size 3.5 Gy and greater) are alternative approaches to hypofractionation, but are beyond the scope of this report. |
| doi_str_mv | 10.1016/j.ctrv.2013.01.008 |
| format | Article |
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Conventionally fractionated external beam radiation therapy (1.8–2.0 Gy/fraction) is an established treatment modality for men in all disease risk groups. Emerging evidence from experimental and clinical studies suggests that the α / β ratio for prostate cancer may be as low as 1.5 Gy, which has prompted investigators around the world to explore moderately hypofractionated radiation therapy (2.1–3.5 Gy/fraction). We review the impetus behind moderate hypofractionation and the current clinical evidence supporting moderate hypofractionated radiation therapy for prostate cancer. Although hypofractionated radiation therapy has many theoretical advantages, there is no clear evidence from prospective, randomized, controlled trials showing that hypofractionated schedules have improved outcomes or lower toxicity than conventionally fractionated regimens. Currently, hypofractionated schedules should only be used in the context of clinical trials. High dose rate brachytherapy and stereotactic body radiation therapy (fraction size 3.5 Gy and greater) are alternative approaches to hypofractionation, but are beyond the scope of this report.</description><identifier>ISSN: 0305-7372</identifier><identifier>EISSN: 1532-1967</identifier><identifier>DOI: 10.1016/j.ctrv.2013.01.008</identifier><identifier>PMID: 23453861</identifier><identifier>CODEN: CTREDJ</identifier><language>eng</language><publisher>Kidlington: Elsevier Ltd</publisher><subject>Antineoplastic agents ; Biological and medical sciences ; Clinical Trials as Topic ; Dose Fractionation ; Gynecology. Andrology. Obstetrics ; Hematology, Oncology and Palliative Medicine ; Humans ; Hypofractionation ; Male ; Male genital diseases ; Medical sciences ; Multiple tumors. Solid tumors. Tumors in childhood (general aspects) ; Neoplasm Staging ; Nephrology. Urinary tract diseases ; Pharmacology. Drug treatments ; Prostate cancer ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - radiotherapy ; Quality of life ; Radiotherapy ; Toxicity ; Treatment Outcome ; Tumors ; Tumors of the urinary system ; Urinary tract. Prostate gland</subject><ispartof>Cancer treatment reviews, 2013-11, Vol.39 (7), p.728-736</ispartof><rights>Elsevier Ltd</rights><rights>2013 Elsevier Ltd</rights><rights>2014 INIST-CNRS</rights><rights>Copyright © 2013 Elsevier Ltd. All rights reserved.</rights><rights>2013 Elsevier Ltd. All rights reserved. 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c606t-66f433884c670930dd922c265ce64bf00748406e0c9f97dbc8590a818e250c1a3</citedby><cites>FETCH-LOGICAL-c606t-66f433884c670930dd922c265ce64bf00748406e0c9f97dbc8590a818e250c1a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ctrv.2013.01.008$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,315,782,786,887,3552,27931,27932,46002</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27671347$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23453861$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zaorsky, Nicholas G</creatorcontrib><creatorcontrib>Ohri, Nitin</creatorcontrib><creatorcontrib>Showalter, Timothy N</creatorcontrib><creatorcontrib>Dicker, Adam P</creatorcontrib><creatorcontrib>Den, Robert B</creatorcontrib><title>Systematic review of hypofractionated radiation therapy for prostate cancer</title><title>Cancer treatment reviews</title><addtitle>Cancer Treat Rev</addtitle><description>Abstract Prostate cancer is the second most prevalent solid tumor diagnosed in men in the United States and Western Europe. Conventionally fractionated external beam radiation therapy (1.8–2.0 Gy/fraction) is an established treatment modality for men in all disease risk groups. Emerging evidence from experimental and clinical studies suggests that the α / β ratio for prostate cancer may be as low as 1.5 Gy, which has prompted investigators around the world to explore moderately hypofractionated radiation therapy (2.1–3.5 Gy/fraction). We review the impetus behind moderate hypofractionation and the current clinical evidence supporting moderate hypofractionated radiation therapy for prostate cancer. Although hypofractionated radiation therapy has many theoretical advantages, there is no clear evidence from prospective, randomized, controlled trials showing that hypofractionated schedules have improved outcomes or lower toxicity than conventionally fractionated regimens. Currently, hypofractionated schedules should only be used in the context of clinical trials. High dose rate brachytherapy and stereotactic body radiation therapy (fraction size 3.5 Gy and greater) are alternative approaches to hypofractionation, but are beyond the scope of this report.</description><subject>Antineoplastic agents</subject><subject>Biological and medical sciences</subject><subject>Clinical Trials as Topic</subject><subject>Dose Fractionation</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Hypofractionation</subject><subject>Male</subject><subject>Male genital diseases</subject><subject>Medical sciences</subject><subject>Multiple tumors. Solid tumors. Tumors in childhood (general aspects)</subject><subject>Neoplasm Staging</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Pharmacology. Drug treatments</subject><subject>Prostate cancer</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>Quality of life</subject><subject>Radiotherapy</subject><subject>Toxicity</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Tumors of the urinary system</subject><subject>Urinary tract. 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Andrology. Obstetrics</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Hypofractionation</topic><topic>Male</topic><topic>Male genital diseases</topic><topic>Medical sciences</topic><topic>Multiple tumors. Solid tumors. Tumors in childhood (general aspects)</topic><topic>Neoplasm Staging</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Pharmacology. Drug treatments</topic><topic>Prostate cancer</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>Quality of life</topic><topic>Radiotherapy</topic><topic>Toxicity</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Tumors of the urinary system</topic><topic>Urinary tract. Prostate gland</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zaorsky, Nicholas G</creatorcontrib><creatorcontrib>Ohri, Nitin</creatorcontrib><creatorcontrib>Showalter, Timothy N</creatorcontrib><creatorcontrib>Dicker, Adam P</creatorcontrib><creatorcontrib>Den, Robert B</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancer treatment reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zaorsky, Nicholas G</au><au>Ohri, Nitin</au><au>Showalter, Timothy N</au><au>Dicker, Adam P</au><au>Den, Robert B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Systematic review of hypofractionated radiation therapy for prostate cancer</atitle><jtitle>Cancer treatment reviews</jtitle><addtitle>Cancer Treat Rev</addtitle><date>2013-11-01</date><risdate>2013</risdate><volume>39</volume><issue>7</issue><spage>728</spage><epage>736</epage><pages>728-736</pages><issn>0305-7372</issn><eissn>1532-1967</eissn><coden>CTREDJ</coden><abstract>Abstract Prostate cancer is the second most prevalent solid tumor diagnosed in men in the United States and Western Europe. Conventionally fractionated external beam radiation therapy (1.8–2.0 Gy/fraction) is an established treatment modality for men in all disease risk groups. Emerging evidence from experimental and clinical studies suggests that the α / β ratio for prostate cancer may be as low as 1.5 Gy, which has prompted investigators around the world to explore moderately hypofractionated radiation therapy (2.1–3.5 Gy/fraction). We review the impetus behind moderate hypofractionation and the current clinical evidence supporting moderate hypofractionated radiation therapy for prostate cancer. Although hypofractionated radiation therapy has many theoretical advantages, there is no clear evidence from prospective, randomized, controlled trials showing that hypofractionated schedules have improved outcomes or lower toxicity than conventionally fractionated regimens. Currently, hypofractionated schedules should only be used in the context of clinical trials. High dose rate brachytherapy and stereotactic body radiation therapy (fraction size 3.5 Gy and greater) are alternative approaches to hypofractionation, but are beyond the scope of this report.</abstract><cop>Kidlington</cop><pub>Elsevier Ltd</pub><pmid>23453861</pmid><doi>10.1016/j.ctrv.2013.01.008</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Antineoplastic agents Biological and medical sciences Clinical Trials as Topic Dose Fractionation Gynecology. Andrology. Obstetrics Hematology, Oncology and Palliative Medicine Humans Hypofractionation Male Male genital diseases Medical sciences Multiple tumors. Solid tumors. Tumors in childhood (general aspects) Neoplasm Staging Nephrology. Urinary tract diseases Pharmacology. Drug treatments Prostate cancer Prostatic Neoplasms - pathology Prostatic Neoplasms - radiotherapy Quality of life Radiotherapy Toxicity Treatment Outcome Tumors Tumors of the urinary system Urinary tract. Prostate gland |
| title | Systematic review of hypofractionated radiation therapy for prostate cancer |
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