PMID- 34352361
OWN - NLM
STAT- MEDLINE
DCOM- 20210914
LR  - 20210914
IS  - 1879-0461 (Electronic)
IS  - 1040-8428 (Linking)
VI  - 165
DP  - 2021 Sep
TI  - Toxicity after moderately hypofractionated versus conventionally fractionated 
      prostate radiotherapy: A systematic review and meta-analysis of the current 
      literature.
PG  - 103432
LID - S1040-8428(21)00220-1 [pii]
LID - 10.1016/j.critrevonc.2021.103432 [doi]
AB  - BACKGROUND: Moderately hypofractionated radiotherapy (RT) currently represents 
      the standard RT approach for all prostate cancer (PCa) risk categories. We 
      performed a systematic review and meta-analysis of available literature, focusing 
      on acute and late genitourinary (GU) and gastrointestinal (GI) adverse events 
      (AEs) of moderate hypofractionation for localized PCa. MATERIALS AND METHODS: 
      Literature search was performed and two independent reviewers selected the 
      records according to the following Population (P) Intervention (I) Comparator (C) 
      and Outcomes (O) (PICO) question: "In patients affected by localized PCa (P), 
      moderately hypofractionated RT (defined as a treatment schedule providing a 
      single dose per fraction of 3-4.5 Gy) (I) can be considered equivalent to 
      conventionally fractionated RT (C) in terms of G > 2 GI and GU acute and late 
      adverse events (O)?". Bias assessment was performed using Cochrane Cochrane 
      Collaboration's Tool for Assessing Risk of Bias. RESULTS: Thirteen records were 
      identified and a meta-analysis was performed. Risk of acute GI and GU > 2 adverse 
      events in the moderately hypofractionated arm was increased by 9.8 % (95 %CI 4.8 
      %-14.7 %; I(2) = 57 %) and 1.5 % (95 % CI -1.5 %-4.4 %; I(2) = 0%), respectively. 
      DISCUSSION: Overall, majority of trials included in our meta-analysis suggested 
      that moderately hypofractionated RT is equivalent, in terms of GI and GU adverse 
      events, to conventional fractionation. Pooled analysis showed a trend to 
      increased GI toxicity after hypofractionated treatment, but this might be related 
      to dose escalation rather than hypofractionation.
CI  - Copyright (c) 2021 Elsevier B.V. All rights reserved.
FAU - Francolini, G
AU  - Francolini G
AD  - Radiation Oncology Unit, University of Florence, Florence, Italy.
FAU - Detti, B
AU  - Detti B
AD  - Radiation Oncology Unit, University of Florence, Florence, Italy. Electronic 
      address: beatrice.detti@aouc.unifi.it.
FAU - Becherini, C
AU  - Becherini C
AD  - Radiation Oncology Unit, University of Florence, Florence, Italy.
FAU - Caini, S
AU  - Caini S
AD  - Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer 
      Research, Prevention and Clinical Network (ISPRO), Florence, Italy.
FAU - Ingrosso, G
AU  - Ingrosso G
AD  - Radiation Oncology Section, Department of Surgical and Biomedical Science, 
      University of Perugia, Italy.
FAU - Di Cataldo, Vanessa
AU  - Di Cataldo V
AD  - Radiation Oncology Unit, University of Florence, Florence, Italy.
FAU - Stocchi, G
AU  - Stocchi G
AD  - Radiation Oncology Unit, University of Florence, Florence, Italy.
FAU - Salvestrini, V
AU  - Salvestrini V
AD  - Radiation Oncology Unit, University of Florence, Florence, Italy.
FAU - Lancia, A
AU  - Lancia A
AD  - Department of Medical Sciences and Infectious Disease, Radiation Oncology Unit, 
      Fondazione IRCCS, Policlinico San Matteo, Pavia, Italy.
FAU - Scartoni, D
AU  - Scartoni D
AD  - Proton Treatment Center, Azienda Provinciale Per i Servizi Sanitari, Trento, 
      Italy.
FAU - Giacomelli, I
AU  - Giacomelli I
AD  - Proton Treatment Center, Azienda Provinciale Per i Servizi Sanitari, Trento, 
      Italy.
FAU - Sardaro, A
AU  - Sardaro A
AD  - Section of Radiology and Radiation Oncology, Interdisciplinary Department of 
      Medicine, University of Bari Aldo Moro, Bari, Italy.
FAU - Carbonara, R
AU  - Carbonara R
AD  - Radiation Oncology Department, General Regional Hospital F. Miulli, Acquaviva 
      delle Fonti, BA, Italy.
FAU - Borghesi, S
AU  - Borghesi S
AD  - Radiotherapy Department, Azienda USL Toscana Sud Est, San Donato Hospital, 
      Arezzo, Italy.
FAU - Aristei, C
AU  - Aristei C
AD  - Radiation Oncology Section, Department of Surgical and Biomedical Science, 
      University of Perugia, Italy.
FAU - Livi, L
AU  - Livi L
AD  - Radiation Oncology Unit, University of Florence, Florence, Italy.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20210803
PL  - Netherlands
TA  - Crit Rev Oncol Hematol
JT  - Critical reviews in oncology/hematology
JID - 8916049
SB  - IM
MH  - Dose Fractionation, Radiation
MH  - *Gastrointestinal Diseases
MH  - Humans
MH  - Male
MH  - *Prostatic Neoplasms/radiotherapy
MH  - Radiation Dose Hypofractionation
MH  - *Radiotherapy, Intensity-Modulated
OTO - NOTNLM
OT  - Hypofractionation
OT  - Prostate
OT  - Toxicity
EDAT- 2021/08/06 06:00
MHDA- 2021/09/15 06:00
CRDT- 2021/08/05 20:16
PHST- 2020/10/12 00:00 [received]
PHST- 2021/07/06 00:00 [revised]
PHST- 2021/07/28 00:00 [accepted]
PHST- 2021/08/06 06:00 [pubmed]
PHST- 2021/09/15 06:00 [medline]
PHST- 2021/08/05 20:16 [entrez]
AID - S1040-8428(21)00220-1 [pii]
AID - 10.1016/j.critrevonc.2021.103432 [doi]
PST - ppublish
SO  - Crit Rev Oncol Hematol. 2021 Sep;165:103432. doi: 
      10.1016/j.critrevonc.2021.103432. Epub 2021 Aug 3.