PMID- 26028229
OWN - NLM
STAT- MEDLINE
DCOM- 20151008
LR  - 20181202
IS  - 1879-0887 (Electronic)
IS  - 0167-8140 (Linking)
VI  - 115
IP  - 3
DP  - 2015 Jun
TI  - What is the ideal radiotherapy dose to treat prostate cancer? A meta-analysis of 
      biologically equivalent dose escalation.
PG  - 295-300
LID - S0167-8140(15)00246-7 [pii]
LID - 10.1016/j.radonc.2015.05.011 [doi]
AB  - PURPOSE: To determine if increasing the biologically equivalent dose (BED) via 
      various radiation fractionation regimens is correlated with clinical outcomes or 
      toxicities for prostate cancer. METHODS AND MATERIALS: We performed a 
      meta-analysis that included 12,756 prostate cancer patients from 55 studies 
      published from 2003 to 2013 who were treated with non-dose-escalated 
      conventionally fractionated external beam radiation therapy (non-DE-CFRT), 
      DE-CFRT, hypofractionated RT, and high dose rate brachytherapy (HDR-BT; either 
      mono or boost) with ⩾5-year actuarial follow-up. BEDs were calculated based on 
      the following formula: (nd[1+d/(alpha/beta)]), where n is the number of fractions, and d 
      is dose per fraction; assuming an alpha/beta of 1.5 for prostate cancer and 3.0 for late 
      toxicities. Mixed effects meta-regression models were used to estimate weighted 
      linear relationships between BED and the observed percentages of patients 
      experiencing late toxicities or 5-year freedom from biochemical failure (FFBF). 
      RESULTS: Increases in 10 Gy increments in BED (at alpha/beta of 1.5) from 140 to 200 Gy 
      were associated with 5-unit improvements in percent FFBF. Dose escalation of BED 
      above 200 Gy was not correlated with FFBF. Increasing BED (at alpha/beta of 3.0) from 98 
      to 133 Gy was associated with increased gastrointestinal toxicity. Dose 
      escalation above 133 Gy was not correlated with toxicity. CONCLUSIONS: An 
      increase in the BED to 200 Gy (at alpha/beta of 1.5) was associated with increased 
      disease control. Doses above 200 Gy did not result in additional clinical 
      benefit.
CI  - Copyright (c) 2015 Elsevier Ireland Ltd. All rights reserved.
FAU - Zaorsky, Nicholas G
AU  - Zaorsky NG
AD  - Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA; 
      Department of Radiation Oncology, Sidney Kimmel Cancer Center at Sidney Kimmel 
      Medical College at Thomas Jefferson University, Philadelphia, PA, USA. Electronic 
      address: nicholaszaorsky@gmail.com.
FAU - Palmer, Joshua D
AU  - Palmer JD
AD  - Department of Radiation Oncology, Sidney Kimmel Cancer Center at Sidney Kimmel 
      Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
FAU - Hurwitz, Mark D
AU  - Hurwitz MD
AD  - Department of Radiation Oncology, Sidney Kimmel Cancer Center at Sidney Kimmel 
      Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
FAU - Keith, Scott W
AU  - Keith SW
AD  - Department of Pharmacology and Experimental Therapeutics, Division of 
      Biostatistics, Sidney Kimmel Medical College at Thomas Jefferson University, 
      Philadelphia, PA, USA.
FAU - Dicker, Adam P
AU  - Dicker AP
AD  - Department of Radiation Oncology, Sidney Kimmel Cancer Center at Sidney Kimmel 
      Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
FAU - Den, Robert B
AU  - Den RB
AD  - Department of Radiation Oncology, Sidney Kimmel Cancer Center at Sidney Kimmel 
      Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20150528
PL  - Ireland
TA  - Radiother Oncol
JT  - Radiotherapy and oncology : journal of the European Society for Therapeutic 
      Radiology and Oncology
JID - 8407192
SB  - IM
MH  - Brachytherapy/methods
MH  - Dose Fractionation, Radiation
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Prostatic Neoplasms/*radiotherapy
MH  - Radiotherapy Dosage
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Prostate cancer
OT  - Radiation oncology
OT  - Radiotherapy dose fractionation
OT  - Technology
EDAT- 2015/06/02 06:00
MHDA- 2015/10/09 06:00
CRDT- 2015/06/02 06:00
PHST- 2014/07/20 00:00 [received]
PHST- 2015/05/03 00:00 [revised]
PHST- 2015/05/08 00:00 [accepted]
PHST- 2015/06/02 06:00 [entrez]
PHST- 2015/06/02 06:00 [pubmed]
PHST- 2015/10/09 06:00 [medline]
AID - S0167-8140(15)00246-7 [pii]
AID - 10.1016/j.radonc.2015.05.011 [doi]
PST - ppublish
SO  - Radiother Oncol. 2015 Jun;115(3):295-300. doi: 10.1016/j.radonc.2015.05.011. Epub 
      2015 May 28.