Hypofractionated radiation therapy versus conventional radiation therapy in prostate cancer: A systematic review of its safety and efficacy

Actas Urol Esp. 2015 Jul-Aug;39(6):367-74. doi: 10.1016/j.acuro.2014.12.005. Epub 2015 Feb 7.
[Article in English, Spanish]

Abstract

Context: New therapeutic alternatives can improve the safety and efficacy of prostate cancer treatment.

Objectives: To assess whether hypofractionated radiation therapy results in better safety and efficacy in the treatment of prostate cancer.

Acquisition of evidence: Systematic review of the literature through searches on PubMed, Cochrane Library, CRD, ClinicalTrials and EuroScan, collecting indicators of safety and efficacy.

Synthesis of the evidence: We included 2 systematic reviews and a clinical trial. In terms of efficacy, there is considerable heterogeneity among the studies, and no conclusive results were found concerning the superiority of the hypofractionated option over the normal fractionated option. In terms of safety, there were no significant differences in the onset of acute genitourinary complications between the 2 treatments. However, one of the reviews found more acute gastrointestinal complications in patients treated with hypofractionated radiation therapy. There were no significant differences in long-term complications based on the type of radiation therapy used, although the studies did have limitations.

Conclusions: To date, there are no conclusive results that show that hypofractionated radiation therapy is more effective or safer than normal fractionated radiation therapy in the treatment of localized prostate cancer.

Keywords: Cáncer de próstata; Hipofraccionamiento; Hypofractionation; Prostate cancer; Radiation therapy; Radioterapia; Revisión sistemática; Systematic Review.

Publication types

  • Comparative Study
  • Review
  • Systematic Review

MeSH terms

  • Adenocarcinoma / radiotherapy*
  • Dose Fractionation, Radiation*
  • Dose-Response Relationship, Radiation
  • Gastrointestinal Diseases / epidemiology
  • Gastrointestinal Diseases / etiology
  • Humans
  • Male
  • Male Urogenital Diseases / epidemiology
  • Male Urogenital Diseases / etiology
  • Meta-Analysis as Topic
  • Organs at Risk
  • Prostatic Neoplasms / radiotherapy*
  • Radiation Injuries / epidemiology
  • Radiation Injuries / etiology
  • Radiotherapy / adverse effects
  • Radiotherapy / methods
  • Randomized Controlled Trials as Topic
  • Treatment Outcome