Efficacy of Radiation Therapy for Prostate Cancer Unclear
Moderate evidence links higher EBRT dose with increased rates of long-term biochemical control
TUESDAY, June 7 (HealthDay News) -- Current evidence is inconclusive regarding the efficacy of radiation treatment compared to no treatment for localized prostate cancer, according to a review published online June 6 in the Annals of Internal Medicine.
Raveendhara R. Bannuru, M.D., from Tufts Medical Center in Boston, and colleagues reviewed 75 studies from MEDLINE and the Cochrane library, including 10 randomized controlled trials (RCTs) and 65 non-randomized studies to update the findings on the effectiveness of different radiation therapies for men with localized prostate cancer who either underwent first-line radiation therapy or received no initial treatment. Two of the RCTs compared different combinations of radiation therapies; seven RCTs investigated different doses and fraction sizes of external beam radiation therapy (EBRT); and one RCT investigated different forms of low-dose radiation therapy. Data included patient samples, radiation treatment characteristics, clinical and biochemical outcomes, adverse events, and potential bias, and were rated for strength of overall evidence. The investigators analyzed heterogeneous outcomes.
The investigators found that there was moderate-strength evidence to indicate that higher EBRT dose was correlated with higher rates of long-term biochemical control compared to a lower dose. The available evidence was insufficient for other comparisons.
"This updated review showed unclear effectiveness of radiation treatments compared with no treatment or no initial treatment for localized prostate cancer on patient survival. Similarly, there was insufficient evidence to determine whether certain forms of radiation treatment were 'more effective' than others," the authors write.