Evidence map›Paper›PMID 39690404›Full record

SynthesisRadiation oncology (London, England)2024

Stereotactic body radiotherapy as metastasis-directed therapy in oligometastatic prostate cancer: a systematic review and meta-analysis of randomized controlled trials.

Astrid E Persson, Andreas Hallqvist, Louise Bjørn Larsen, Mette Rasmussen, Jonas Scherman, Per Nilsson, Hanne Tønnesen, Adalsteinn Gunnlaugsson

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Radiation oncology (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Astrid E PerssonDivision of Oncology, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden. astrid.persson@med.lu.se.
Andreas Hallqvist *Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Louise Bjørn Larsen *Department of Oncology, Herlev Hospital, Copenhagen University Hospitals, Herlev, Denmark.
Mette RasmussenNational Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
Jonas SchermanDepartment of Hematology, Oncology, and Radiation Physics, Skåne University Hospital, Lund, Sweden.
Per NilssonDivision of Oncology, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
Hanne TønnesenClinical Health Promotion Centre, Department of Health Sciences, Lund University, Lund, Sweden.
Adalsteinn GunnlaugssonDivision of Oncology, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.

Funding

The Oak Foundation OCAY-13-309
6 · The paper itself

Abstract

backgroundThe use of stereotactic body radiotherapy (SBRT) to definitively treat oligometastases in prostate cancer has drawn large clinical and research interests within radiation oncology. However, the evidence is considered in its early stages and there is currently no systematic review of randomized controlled trials (RCTs) in this field. We aimed to evaluate the efficacy and safety of SBRT as metastasis-directed therapy (MDT) in oligometastatic prostate cancer (OMPC) compared to no MDT reported in RCTs.

methodsMEDLINE, Embase, CINAHL Complete, and Cochrane Library were searched on October 28, 2023. Eligible studies were RCTs comparing SBRT as MDT with no MDT in extracranial OMPC, without restrictions on follow-up time, publication status, language, or year. Participant subsets fulfilling the eligibility criteria were included. Critical outcomes were overall survival and grade ≥ 3 toxicity, and additional important outcomes were progression-free survival (PFS), local control, grade 5 toxicity, health-related quality of life, and systemic therapy-free survival. Meta-analyses were planned. Risk of bias was assessed using the Cochrane risk-of-bias tool version 2, and the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation.

resultsIn total, 1825 unique study reports were identified and seven phase II RCTs with 559 eligible participants were included. Four trials included multiple types of primary cancer. Outcome definitions were heterogeneous except for overall survival and toxicity. For overall survival, only one study reported events in both arms. Meta-analysis of the grade ≥ 3 toxicity results from two trials showed no difference (pooled risk ratio 0.78, 95% confidence interval 0.37-1.65, p = 0.52). Four trials reported significantly longer PFS, with a pooled hazard ratio of 0.31 (95% confidence interval 0.21-0.45, p < 0.00001). Risk of bias was of some concerns or high. Quality of evidence was low or moderate.

conclusionsPhase II trials have shown promising improvements in PFS for several OMPC states without excess toxicity. Overall survival comparisons are immature. In future confirmatory phase III trials, adequately large sample sizes, blinding of outcome assessors, and/or increased adherence to assigned intervention could improve the quality of evidence. PROSPERO registration number: CRD42021230131.

Indexed as

Prostatic NeoplasmsRadiosurgeryHumansMaleNeoplasm MetastasisRandomized Controlled Trials as TopicMeta-analysisMetastasis-directed therapyOligometastatic diseaseProstate cancerRandomized controlled trialsStereotactic body radiotherapySystematic review

Identifiers

PMID39690404
PMCPMC11654405

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.