Evidence map›Paper›PMID 33309278›Full record

SynthesisEuropean urology2021

A Systematic Review and Meta-analysis of Local Salvage Therapies After Radiotherapy for Prostate Cancer (MASTER).

Luca F Valle, Eric J Lehrer, Daniela Markovic, David Elashoff, Rebecca Levin-Epstein, R Jeffery Karnes, Robert E Reiter, Matthew Rettig, Jeremie Calais, Nicholas G Nickols and 7 more

2 registry-linked trialsOpen access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European urology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 149 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
149citing papers in PubMed, 10 pooled it
17.6field-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.

NCT06201078 phase2recruitingnot on this mapstarted 2023, after this paper: background citation

Phase II Study - Stereotactic Re-irradiation of Local Recurrences of Prostate Cancer After Radiotherapy - PROSTARE (PROstate Cancer STereotActic REirradiation) Trial

TypeinterventionalSponsorMaria Sklodowska-Curie National Research Institute of OncologyRan2023 to 2029Enrolled55ConditionsLocal Recurrence of Malignant Tumor of Prostate, RadiotherapyArmsStereotactic Body Radiotherapy
NCT06964412 naactive not recruitingnot on this mapstarted 2026, after this paper: background citation

A Phase II Randomized Study of the Use of Artificial Intelligence Generated Contours in Ultrasound-based Prostate HDR Brachytherapy

TypeinterventionalSponsorBrigham and Women's HospitalRan2026 to 2028Enrolled36ConditionsProstate CancerArmsArtificial-intelligence (AI)
3 · Its place in the literature

Who cites it

149 citing papers in PubMed, 10 syntheses or guidelines pooled it, 284 citations in OpenAlex.

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 6 institutions in 1 country.

Luca F ValleDepartment of Radiation Oncology, University of California, Los Angeles, CA, USA.
Eric J LehrerDepartment of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
Daniela MarkovicDepartment of Medicine, Statistics Core, University of California, Los Angeles, CA, USA.
David ElashoffDepartment of Medicine, Statistics Core, University of California, Los Angeles, CA, USA.
Rebecca Levin-EpsteinDepartment of Radiation Oncology, University of California, Los Angeles, CA, USA.
R Jeffery KarnesDepartment of Urology, Mayo Clinic, Rochester, MN, USA.
Robert E ReiterDepartment of Urology, University of California, Los Angeles, CA, USA.
Matthew RettigDivision of Hematology and Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA; Division of Hematology and Oncology, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Jeremie CalaisAhmanson Translational Theranostics Division, Department of Molecular & Medical Pharmacology, University of California, Los Angeles, CA, USA.
Nicholas G NickolsDepartment of Radiation Oncology, University of California, Los Angeles, CA, USA; Department of Radiation Oncology, Veteran Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Robert T DessDepartment of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA.
Daniel E SprattDepartment of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA.
Michael L SteinbergDepartment of Radiation Oncology, University of California, Los Angeles, CA, USA.
Paul L NguyenDepartment of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Brian J DavisDepartment of Radiation Oncology, Mayo Clinic, Rochester, MN, USA.
Nicholas G ZaorskyDepartment of Radiation Oncology, Penn State Cancer Institute, Hershey, PA, USA.
Amar U KishanDepartment of Radiation Oncology, University of California, Los Angeles, CA, USA; Department of Urology, University of California, Los Angeles, CA, USA. Electronic address: aukishan@mednet.ucla.edu.
University of California, Los Angeles · USMayo Clinic in Arizona · USUniversity of Michigan · USBrigham and Women's Hospital · USIcahn School of Medicine at Mount Sinai · USPenn State Milton S. Hershey Medical Center · US

Funding

UCLA SPORE IN PROSTATE CANCERP50CA092131 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI REITER, ROBERT E · 2002 to 2023
$42.6M
NCI NIH HHS P50 CA092131
6 · The paper itself

Abstract

contextManagement of locally recurrent prostate cancer after definitive radiotherapy remains controversial due to the perceived high rates of severe genitourinary (GU) and gastrointestinal (GI) toxicity associated with any local salvage modality.

objectiveTo quantitatively compare the efficacy and toxicity of salvage radical prostatectomy (RP), high-intensity focused ultrasound (HIFU), cryotherapy, stereotactic body radiotherapy (SBRT), low-dose-rate (LDR) brachytherapy, and high-dose-rate (HDR) brachytherapy. EVIDENCE ACQUISITION: We performed a systematic review of PubMed, EMBASE, and MEDLINE. Two- and 5-yr recurrence-free survival (RFS) rates and crude incidences of severe GU and GI toxicity were extracted as endpoints of interest. Random-effect meta-analyses were conducted to characterize summary effect sizes and quantify heterogeneity. Estimates for each modality were then compared with RP after adjusting for individual study-level covariates using mixed-effect regression models, while allowing for differences in between-study variance across treatment modalities. EVIDENCE SYNTHESIS: A total of 150 studies were included for analysis. There was significant heterogeneity between studies within each modality, and covariates differed between modalities, necessitating adjustment. Adjusted 5-yr RFS ranged from 50% after cryotherapy to 60% after HDR brachytherapy and SBRT, with no significant differences between any modality and RP. Severe GU toxicity was significantly lower with all three forms of radiotherapeutic salvage than with RP (adjusted rates of 20% after RP vs 5.6%, 9.6%, and 9.1% after SBRT, HDR brachytherapy, and LDR brachytherapy, respectively; p ≤ 0.001 for all). Severe GI toxicity was significantly lower with HDR salvage than with RP (adjusted rates 1.8% vs 0.0%, p < 0.01), with no other differences identified.

conclusionsLarge differences in 5-yr outcomes were not uncovered when comparing all salvage treatment modalities against RP. Reirradiation with SBRT, HDR brachytherapy, or LDR brachytherapy appears to result in less severe GU toxicity than RP, and reirradiation with HDR brachytherapy yields less severe GI toxicity than RP. Prospective studies of local salvage for radiorecurrent disease are warranted. PATIENT SUMMARY: In a large study-level meta-analysis, we looked at treatment outcomes and toxicity for men treated with a number of salvage treatments for radiorecurrent prostate cancer. We conclude that relapse-free survival at 5 years is equivalent among salvage modalities, but reirradiation may lead to lower toxicity.

Indexed as

Neoplasm Recurrence, LocalProstatic NeoplasmsSalvage TherapyBrachytherapyCryotherapyHigh-Intensity Focused Ultrasound AblationHumansMaleProspective StudiesProstatectomyRadiation DosageRadiosurgeryCryotherapyHigh-dose-rate brachytherapyHigh-intensity focused ultrasoundLow–dose-rate brachytherapyMeta-analysisProstate cancerRadiation therapyRadical prostatectomyRadiorecurrent prostate cancerSalvage therapyStereotactic body radiotherapy

Identifiers

PMID33309278
PMCPMC10262981
OpenAlexW3112578742

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

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.