Evidence map›Paper›PMID 34400799›Full record

SynthesisProstate cancer and prostatic diseases2022

Radiation therapy dose and androgen deprivation therapy in localized prostate cancer: a meta-regression of 5-year outcomes in phase III randomized controlled trials.

Tommy Jiang, Daniela Markovic, Jay Patel, Jesus E Juarez, Ting Martin Ma, David Shabsovich, Nicholas G Nickols, Robert E Reiter, David Elashoff, Matthew B Rettig and 3 more

Open access · hybridAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Prostate cancer and prostatic diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.6field-weighted citation impact, top 15% 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

7 citing papers in PubMed, 13 citations in OpenAlex.

  1. Trial
  2. Intensity modulated radiation therapy in prostate cancer-Better survival with higher total dose?Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025
    Article
  3. Article
  4. Review
  5. mCRPC Patients ReceivingJournal of nuclear medicine : official publication, Society of Nuclear Medicine · 2022
    Article
  6. Article
  7. 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

13 authors at 3 institutions in 1 country.

Tommy JiangDepartment of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.ORCID http://orcid.org/0000-0002-1199-0615
Daniela MarkovicDepartment of Medicine, Statistics Core, University of California, Los Angeles, CA, USA.
Jay PatelDepartment of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Jesus E JuarezDepartment of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Ting Martin MaDepartment of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
David ShabsovichDepartment of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Nicholas G NickolsDepartment of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Robert E ReiterDepartment of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
David ElashoffDepartment of Medicine, Statistics Core, University of California, Los Angeles, CA, USA.
Matthew B RettigDivision of Hematology and Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Nicholas G ZaorskyDepartment of Radiation Oncology, Penn State Cancer Institute, Hershey, PA, USA.
Daniel E SprattDepartment of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA.ORCID http://orcid.org/0000-0002-5973-4741
Amar U KishanDepartment of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA. aukishan@mednet.ucla.edu.ORCID http://orcid.org/0000-0002-7437-6591
University of California, Los Angeles · USPenn State Milton S. Hershey Medical Center · USUniversity of Michigan · US

Funding

Women's CancersP30CA016042 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Samuel Wheeler French · 1985 to 2026
$134.5M
NCI NIH HHS P30 CA016042
6 · The paper itself

Abstract

backgroundWhile multiple randomized trials have evaluated the benefit of radiation therapy (RT) dose escalation and the use and prolongation of androgen deprivation therapy (ADT) in the treatment of prostate cancer, few studies have evaluated the relative benefit of either form of treatment intensification with each other. Many trials have included treatment strategies that incorporate either high or low dose RT, or short-term or long-term ADT (STADT or LTADT), in one or more trial arms. We sought to compare different forms of treatment intensification of RT in the context of localized prostate cancer.

methodsUsing preferred reporting items for systemic reviews and meta-analyses (PRISMA) guidelines, we collected over 40 phases III clinical trials comparing different forms of RT for localized prostate cancer. We performed a meta-regression of 40 individual trials with 21,429 total patients to allow a comparison of the rates and cumulative proportions of 5-year overall survival (OS), prostate cancer-specific mortality (PCSM), and distant metastasis (DM) for each treatment arm of every trial.

resultsDose-escalation either in the absence or presence of STADT failed to significantly improve any 5-year outcome. In contrast, adding LTADT to low dose RT significantly improved 5-year PCSM (Odds ratio [OR] 0.34, 95% confidence interval [CI] 0.22-0.54, p < 0.001) and DM (OR 0.35, 95% CI 0.20-0.63. p < 0.001) over low dose RT alone. Adding STADT also significantly improved 5-year PCSM over low dose RT alone (OR 0.55, 95% CI 0.41-0.75, p < 0.001).

conclusionWhile limited by between-study heterogeneity and a lack of individual patient data, this meta-analysis suggests that adding ADT, versus increasing RT dose alone, offers a more consistent improvement in clinical endpoints.

Indexed as

Androgen AntagonistsProstatic NeoplasmsAndrogensClinical Trials, Phase III as TopicHormone Replacement TherapyHumansMaleRandomized Controlled Trials as TopicAndrogen AntagonistsAndrogens

Identifiers

PMID34400799
PMCPMC9018418
OpenAlexW3195915034

What OpenQuestion 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 OpenQuestion graph.