Clinical Efficacy and Safety of Proton and Carbon Ion Radiotherapy for Prostate Cancer: A Systematic Review and Meta-Analysis

doi:10.3389/fonc.2021.709530

	Clinical Efficacy and Safety of Proton and Carbon Ion Radiotherapy for Prostate Cancer: A Systematic Review and Meta-Analysis
	Li, Meixuan 2,3,4,9; Li, Xiuxia 2,3,4,9; Yao, Liang 5; Han, Xue 1; Yan, Wenlong 6; Liu, Yujun 6; Fu, Yiwen 1; Wang, Yakun 6; Huang, Min 6; Zhang, Qiuning 7,8
刊名	FRONTIERS IN ONCOLOGY
	2021-10-12
卷号	11 页码:15
关键词	proton beam therapy carbon ion radiotherapy prostate cancer efficacy safety meta-analysis
ISSN号	2234-943X
DOI	10.3389/fonc.2021.709530
通讯作者	Wang, Xiaohu(yangkh-ebm@lzu.edu.cn) ; Yang, Kehu(ebm2019@126.com)
英文摘要	Background:& nbsp;Carbon ion radiotherapy (CIRT) and proton beam therapy (PBT) are promising methods for prostate cancer, however, the consensus of an increasing number of studies has not been reached. We aimed to provide systematic evidence for evaluating the efficacy and safety of CIRT and PBT for prostate cancer by comparing photon radiotherapy. Materials and Methods:& nbsp;We searched for studies focusing on CIRT and PBT for prostate cancer in four online databases until July 2021. Two independent reviewers assessed the quality of included studies and used the GRADE approach to rate the quality of evidence. R 4.0.2 software was used to conduct the meta-analysis. A meta-regression test was performed based on the study design and tumor stage of each study. Results:& nbsp;A total of 33 studies including 13 CIRT- and 20 PBT-related publications, involving 54,101, participants were included. The quality of the included studies was found to be either low or moderate quality. Random model single-arm meta-analysis showed that both the CIRT and PBT have favorable efficacy and safety, with similar 5-year overall survival (OS) (94 vs 92%), the incidence of grade 2 or greater acute genitourinary (AGU) toxicity (5 vs 13%), late genitourinary (LGU) toxicity (4 vs 5%), acute gastrointestinal (AGI) toxicity (1 vs 1%), and late gastrointestinal (LGI) toxicity (2 vs 4%). However, compared with CIRT and PBT, photon radiotherapy was associated with lower 5-year OS (72-73%) and a higher incidence of grade 2 or greater AGU (28-29%), LGU (13-14%), AGI (14-19%), and LGI toxicity (8-10%). The meta-analysis showed the 3-, 4-, and 5-year local control rate (LCR) of CIRT for prostate cancer was 98, 97, and 99%; the 3-, 4-, 5-, and 8-year biochemical relapse-free rate (BRF) was 92, 91, 89, and 79%. GRADE assessment results indicated that the certainty of the evidence was very low. Meta-regression results did not show a significant relationship based on the variables studied (P < 0.05). Conclusions:& nbsp;Currently available evidence demonstrated that the efficacy and safety of CIRT and PBT for prostate cancer were similar, and they may significantly improve the OS, LCR, and reduce the incidence of GU and GI toxicity compared with photon radiotherapy. However, the quantity and quality of the available evidence are insufficient. More high-quality controlled studies are needed in the future.
资助项目	National Social Science Fund of China[19ZDA142] ; Key Laboratory of Evidence-Based Medicine and Knowledge Translation Foundation of Gansu Province[GSEBMKT-2020KF01]
WOS关键词	QUALITY-OF-LIFE ; INTENSITY-MODULATED RADIOTHERAPY ; LONG-TERM OUTCOMES ; BEAM THERAPY ; RADIATION-THERAPY ; ACUTE TOXICITY ; PHASE-II ; METHODOLOGICAL QUALITY ; CONFORMAL RADIOTHERAPY ; 5-YEAR OUTCOMES
WOS研究方向	Oncology
语种	英语
出版者	FRONTIERS MEDIA SA
WOS记录号	WOS:000713418900001
资助机构	National Social Science Fund of China ; Key Laboratory of Evidence-Based Medicine and Knowledge Translation Foundation of Gansu Province
内容类型	期刊论文
源URL	[http://119.78.100.186/handle/113462/138289]
专题	中国科学院近代物理研究所
通讯作者	Wang, Xiaohu; Yang, Kehu
作者单位	1.Lanzhou Univ, Sch Clin Med 2, Lanzhou, Peoples R China 2.Lanzhou Univ, Sch Basic Med Sci, Evidence Based Med Ctr, Lanzhou, Peoples R China 3.Lanzhou Univ, Sch Publ Hlth, Evidence Based Social Sci Res Ctr, Lanzhou, Peoples R China 4.Lanzhou Univ, Sch Publ Hlth, Hlth Technol Assessment Ctr, Lanzhou, Peoples R China 5.McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada 6.Lanzhou Univ, Sch Clin Med 1, Lanzhou, Peoples R China 7.Lanzhou Heavy Ions Hosp, Lanzhou, Peoples R China 8.Chinese Acad Sci, Inst Modern Phys, Lanzhou, Peoples R China 9.Key Lab Evidence Based Med & Knowledge Translat G, Lanzhou, Peoples R China
推荐引用方式 GB/T 7714	Li, Meixuan,Li, Xiuxia,Yao, Liang,et al. Clinical Efficacy and Safety of Proton and Carbon Ion Radiotherapy for Prostate Cancer: A Systematic Review and Meta-Analysis[J]. FRONTIERS IN ONCOLOGY,2021,11:15.
APA	Li, Meixuan.,Li, Xiuxia.,Yao, Liang.,Han, Xue.,Yan, Wenlong.,...&Yang, Kehu.(2021).Clinical Efficacy and Safety of Proton and Carbon Ion Radiotherapy for Prostate Cancer: A Systematic Review and Meta-Analysis.FRONTIERS IN ONCOLOGY,11,15.
MLA	Li, Meixuan,et al."Clinical Efficacy and Safety of Proton and Carbon Ion Radiotherapy for Prostate Cancer: A Systematic Review and Meta-Analysis".FRONTIERS IN ONCOLOGY 11(2021):15.