Evidence map›Paper›PMID 30106637›Full record

Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2018

Randomized Trial of Hypofractionated, Dose-Escalated, Intensity-Modulated Radiation Therapy (IMRT) Versus Conventionally Fractionated IMRT for Localized Prostate Cancer.

Karen E Hoffman, K Ranh Voong, Lawrence B Levy, Pamela K Allen, Seungtaek Choi, Pamela J Schlembach, Andrew K Lee, Sean E McGuire, Quynh Nguyen, Thomas J Pugh and 4 more

Open access · greenAbstract readClinical Trial, Phase IIIRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed, 7 pooled it
13.7field-weighted citation impact, top 1% of its field
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

69 citing papers in PubMed, 7 syntheses or guidelines pooled it, 132 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Hypofractionation for clinically localized prostate cancer.The Cochrane database of systematic reviews · 2019
    Pooled it
  7. Pooled it
  8. Trial
  9. Trial
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Review
  15. Review
  16. Article
  17. Article
  18. Article
  19. The Proteogenomics of Prostate Cancer Radioresistance.Cancer research communications · 2024
    Article
  20. Review

9 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 1 institution in 1 country.

Karen E HoffmanKaren E. Hoffman, Lawrence B. Levy, Pamela K. Allen, Seungtaek Choi, Pamela J. Schlembach, Sean E. McGuire, Quynh Nguyen, Steven J. Frank, Rajat J. Kudchadker, Weiliang Du, and Deborah A. Kuban, The University of Texas, MD Anderson Cancer Center, Houston; Andrew K. Lee, Texas Center for Proton Therapy, Irving, TX; K. Ranh Voong, The Johns Hopkins Hospital, Baltimore, MD; and Thomas J. Pugh, University of Colorado School of Medicine, Boulder, CO.
K Ranh VoongKaren E. Hoffman, Lawrence B. Levy, Pamela K. Allen, Seungtaek Choi, Pamela J. Schlembach, Sean E. McGuire, Quynh Nguyen, Steven J. Frank, Rajat J. Kudchadker, Weiliang Du, and Deborah A. Kuban, The University of Texas, MD Anderson Cancer Center, Houston; Andrew K. Lee, Texas Center for Proton Therapy, Irving, TX; K. Ranh Voong, The Johns Hopkins Hospital, Baltimore, MD; and Thomas J. Pugh, University of Colorado School of Medicine, Boulder, CO.
Lawrence B LevyKaren E. Hoffman, Lawrence B. Levy, Pamela K. Allen, Seungtaek Choi, Pamela J. Schlembach, Sean E. McGuire, Quynh Nguyen, Steven J. Frank, Rajat J. Kudchadker, Weiliang Du, and Deborah A. Kuban, The University of Texas, MD Anderson Cancer Center, Houston; Andrew K. Lee, Texas Center for Proton Therapy, Irving, TX; K. Ranh Voong, The Johns Hopkins Hospital, Baltimore, MD; and Thomas J. Pugh, University of Colorado School of Medicine, Boulder, CO.
Pamela K AllenKaren E. Hoffman, Lawrence B. Levy, Pamela K. Allen, Seungtaek Choi, Pamela J. Schlembach, Sean E. McGuire, Quynh Nguyen, Steven J. Frank, Rajat J. Kudchadker, Weiliang Du, and Deborah A. Kuban, The University of Texas, MD Anderson Cancer Center, Houston; Andrew K. Lee, Texas Center for Proton Therapy, Irving, TX; K. Ranh Voong, The Johns Hopkins Hospital, Baltimore, MD; and Thomas J. Pugh, University of Colorado School of Medicine, Boulder, CO.
Seungtaek ChoiKaren E. Hoffman, Lawrence B. Levy, Pamela K. Allen, Seungtaek Choi, Pamela J. Schlembach, Sean E. McGuire, Quynh Nguyen, Steven J. Frank, Rajat J. Kudchadker, Weiliang Du, and Deborah A. Kuban, The University of Texas, MD Anderson Cancer Center, Houston; Andrew K. Lee, Texas Center for Proton Therapy, Irving, TX; K. Ranh Voong, The Johns Hopkins Hospital, Baltimore, MD; and Thomas J. Pugh, University of Colorado School of Medicine, Boulder, CO.
Pamela J SchlembachKaren E. Hoffman, Lawrence B. Levy, Pamela K. Allen, Seungtaek Choi, Pamela J. Schlembach, Sean E. McGuire, Quynh Nguyen, Steven J. Frank, Rajat J. Kudchadker, Weiliang Du, and Deborah A. Kuban, The University of Texas, MD Anderson Cancer Center, Houston; Andrew K. Lee, Texas Center for Proton Therapy, Irving, TX; K. Ranh Voong, The Johns Hopkins Hospital, Baltimore, MD; and Thomas J. Pugh, University of Colorado School of Medicine, Boulder, CO.
Andrew K LeeKaren E. Hoffman, Lawrence B. Levy, Pamela K. Allen, Seungtaek Choi, Pamela J. Schlembach, Sean E. McGuire, Quynh Nguyen, Steven J. Frank, Rajat J. Kudchadker, Weiliang Du, and Deborah A. Kuban, The University of Texas, MD Anderson Cancer Center, Houston; Andrew K. Lee, Texas Center for Proton Therapy, Irving, TX; K. Ranh Voong, The Johns Hopkins Hospital, Baltimore, MD; and Thomas J. Pugh, University of Colorado School of Medicine, Boulder, CO.
Sean E McGuireKaren E. Hoffman, Lawrence B. Levy, Pamela K. Allen, Seungtaek Choi, Pamela J. Schlembach, Sean E. McGuire, Quynh Nguyen, Steven J. Frank, Rajat J. Kudchadker, Weiliang Du, and Deborah A. Kuban, The University of Texas, MD Anderson Cancer Center, Houston; Andrew K. Lee, Texas Center for Proton Therapy, Irving, TX; K. Ranh Voong, The Johns Hopkins Hospital, Baltimore, MD; and Thomas J. Pugh, University of Colorado School of Medicine, Boulder, CO.
Quynh NguyenKaren E. Hoffman, Lawrence B. Levy, Pamela K. Allen, Seungtaek Choi, Pamela J. Schlembach, Sean E. McGuire, Quynh Nguyen, Steven J. Frank, Rajat J. Kudchadker, Weiliang Du, and Deborah A. Kuban, The University of Texas, MD Anderson Cancer Center, Houston; Andrew K. Lee, Texas Center for Proton Therapy, Irving, TX; K. Ranh Voong, The Johns Hopkins Hospital, Baltimore, MD; and Thomas J. Pugh, University of Colorado School of Medicine, Boulder, CO.
Thomas J PughKaren E. Hoffman, Lawrence B. Levy, Pamela K. Allen, Seungtaek Choi, Pamela J. Schlembach, Sean E. McGuire, Quynh Nguyen, Steven J. Frank, Rajat J. Kudchadker, Weiliang Du, and Deborah A. Kuban, The University of Texas, MD Anderson Cancer Center, Houston; Andrew K. Lee, Texas Center for Proton Therapy, Irving, TX; K. Ranh Voong, The Johns Hopkins Hospital, Baltimore, MD; and Thomas J. Pugh, University of Colorado School of Medicine, Boulder, CO.
Steven J FrankKaren E. Hoffman, Lawrence B. Levy, Pamela K. Allen, Seungtaek Choi, Pamela J. Schlembach, Sean E. McGuire, Quynh Nguyen, Steven J. Frank, Rajat J. Kudchadker, Weiliang Du, and Deborah A. Kuban, The University of Texas, MD Anderson Cancer Center, Houston; Andrew K. Lee, Texas Center for Proton Therapy, Irving, TX; K. Ranh Voong, The Johns Hopkins Hospital, Baltimore, MD; and Thomas J. Pugh, University of Colorado School of Medicine, Boulder, CO.
Rajat J KudchadkerKaren E. Hoffman, Lawrence B. Levy, Pamela K. Allen, Seungtaek Choi, Pamela J. Schlembach, Sean E. McGuire, Quynh Nguyen, Steven J. Frank, Rajat J. Kudchadker, Weiliang Du, and Deborah A. Kuban, The University of Texas, MD Anderson Cancer Center, Houston; Andrew K. Lee, Texas Center for Proton Therapy, Irving, TX; K. Ranh Voong, The Johns Hopkins Hospital, Baltimore, MD; and Thomas J. Pugh, University of Colorado School of Medicine, Boulder, CO.
Weiliang DuKaren E. Hoffman, Lawrence B. Levy, Pamela K. Allen, Seungtaek Choi, Pamela J. Schlembach, Sean E. McGuire, Quynh Nguyen, Steven J. Frank, Rajat J. Kudchadker, Weiliang Du, and Deborah A. Kuban, The University of Texas, MD Anderson Cancer Center, Houston; Andrew K. Lee, Texas Center for Proton Therapy, Irving, TX; K. Ranh Voong, The Johns Hopkins Hospital, Baltimore, MD; and Thomas J. Pugh, University of Colorado School of Medicine, Boulder, CO.
Deborah A KubanKaren E. Hoffman, Lawrence B. Levy, Pamela K. Allen, Seungtaek Choi, Pamela J. Schlembach, Sean E. McGuire, Quynh Nguyen, Steven J. Frank, Rajat J. Kudchadker, Weiliang Du, and Deborah A. Kuban, The University of Texas, MD Anderson Cancer Center, Houston; Andrew K. Lee, Texas Center for Proton Therapy, Irving, TX; K. Ranh Voong, The Johns Hopkins Hospital, Baltimore, MD; and Thomas J. Pugh, University of Colorado School of Medicine, Boulder, CO.
The University of Texas MD Anderson Cancer Center · US

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Scott Kopetz · 1985 to 2026
$290.8M
NCI NIH HHS P30 CA016672
6 · The paper itself

Abstract

purposeHypofractionated radiotherapy delivers larger daily doses of radiation and may increase the biologically effective dose delivered to the prostate. We conducted a randomized trial testing the hypothesis that dose-escalated, moderately hypofractionated intensity-modulated radiation therapy (HIMRT) improves prostate cancer control compared with conventionally fractionated IMRT (CIMRT) for men with localized prostate cancer. PATIENTS AND

methodsMen were randomly assigned to 75.6 Gy in 1.8-Gy fractions delivered over 8.4 weeks (CIMRT) or 72 Gy in 2.4 Gy fractions delivered over 6 weeks (HIMRT, biologically equivalent to 85 Gy in 1.8-Gy fractions assuming prostate cancer α-to-β ratio of 1.5). Failure was defined as prostate-specific antigen (PSA) failure (nadir plus 2 ng/mL) or initiation of salvage therapy. Modified Radiation Therapy Oncology Group criteria were used to grade late (≥ 90 days after completion of radiotherapy) GI and genitourinary toxicity.

resultsMost of the 206 men (72%) had cT1, Gleason score 6 or 7 (99%), and PSA level ≤ 10 ng/mL (90%) disease. Androgen deprivation therapy was received by 24%. With a median follow-up of 8.5 years, men treated with HIMRT experienced fewer treatment failures (n = 10) than men treated with CIMRT (n = 21; P = .036). The 8-year failure rate was 10.7% (95% CI, 5.8% to 19.1%) with HIMRT and 15.4% (95% CI, 9.1% to 25.4%) with CIMRT. There was no difference in overall survival ( P = .39). There was a nonsignificant increase in late grade 2 or 3 GI toxicity with HIMRT (8-year 5.0% v 12.6%; P = .08). However, GI toxicity was only 8.6% when rectal volume receiving 65 Gy of HIMRT was ≤ 15%. Late genitourinary toxicity was similar ( P = .84). There was no grade 4 toxicity.

conclusionThe results of this randomized trial demonstrate superior cancer control for men with localized prostate cancer who receive dose-escalated moderately hypofractionation radiotherapy while shortening treatment duration.

Indexed as

AdultAgedDose Fractionation, RadiationHumansIncidenceMaleMiddle AgedProstatic NeoplasmsRadiation Dose HypofractionationRadiation InjuriesRadiotherapy, Intensity-Modulated

Identifiers

PMID30106637
PMCPMC6804854
OpenAlexW2885658755

What OpenQuestion holds

Textmetadata
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 OpenQuestion graph.