Evidence map›Paper›PMID 35086762›Full record

ArticleClinical genitourinary cancer2022

Propensity-Weighted Survival Analysis of SBRT vs. Conventional Radiotherapy in Unfavorable Intermediate-Risk Prostate Cancer.

Neal Andruska, Benjamin W Fischer-Valuck, Temitope Agabalogun, Ruben Carmona, Randall J Brenneman, Yi Huang, Hiram A Gay, Jeff M Michalski, Brian C Baumann

Open access · greenAbstract read
In one paragraph

Article in Clinical genitourinary cancer, 2022. 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
0.4field-weighted citation impact, top 34% 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

2 citing papers in PubMed, 5 citations in OpenAlex.

  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

9 authors at 3 institutions in 1 country.

Neal AndruskaDepartment of Radiation Oncology, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO. Electronic address: andruska.neal@wustl.edu.
Benjamin W Fischer-ValuckDepartment of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA.
Temitope AgabalogunDepartment of Radiation Oncology, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO.
Ruben CarmonaDepartment of Radiation Oncology, Sylvester Cancer Center, University of Miami, FL.
Randall J BrennemanDepartment of Radiation Oncology, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO.
Yi HuangBiostatistics, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO.
Hiram A GayDepartment of Radiation Oncology, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO.
Jeff M MichalskiDepartment of Radiation Oncology, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO.
Brian C BaumannDepartment of Radiation Oncology, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Department of Radiation Oncology, Abramson Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, PA. Electronic address: brian.baumann@wustl.edu.
Washington University in St. Louis · USEmory University · USUniversity of Miami · US

Funding

Washington University Center for Cellular ImagingP30CA091842 · NCI · WASHINGTON UNIVERSITY · PI AIMEE S JAMES · 2001 to 2026
$128.0M
NCI NIH HHS P30 CA091842
6 · The paper itself

Abstract

backgroundProstate stereotactic body radiotherapy (SBRT), which delivers high-dose precision treatment in ≤5 fractions, is a shorter, more convenient, and less expensive alternative to conventionally fractionated radiotherapy (CRFT; ∼44 fractions) or moderately hypofractionated radiotherapy (MFRT; 20-28 fractions). SBRT has not been widely adopted but may have radiobiologic advantages over CFRT/MFRT. We hypothesized that SBRT would be associated with improved overall survival (OS) versus CFRT or MFRT ± androgen deprivation therapy (ADT) for unfavorable-intermediate-risk prostate cancer (UIR-PCa).

methodsMen with UIR-PCa treated with SBRT (35-40Gy in ≤5 fractions) or biologically equivalent doses of CFRT (72-86.4Gy in 1.8-2.0Gy/fraction) or MRFT (≥60Gy in 2.4-3.2Gy/fraction; biologically effective doses ≥120) were identified in the National Cancer Database (NCDB). Unweighted and propensity-weighted multivariable Cox analysis (MVA) was used to compare OS hazard ratios.

resultsOf 28,028 men with UIR-PCa who received CFRT with (n = 12,872) or without ADT (n = 12,984); MFRT with (n = 251) or without ADT (n = 281); and SBRT with (n = 212) or without ADT (n = 1,428) were identified. Relative to CFRT without ADT, CFRT+ ADT (HR 0.92, 95% CI 0.87-0.97, P = .002) and SBRT without ADT (HR 0.74, 95% CI 0.61-0.89, P = .002) were both associated with improved OS on MVA. Relative to CFRT+ADT, SBRT without ADT correlated with improved OS on MVA (HR:0.81, 95% CI 0.67-0.99, P = .04). Propensity-weighted MVA demonstrated that SBRT (HR:0.80, 95% CI 0.65-0.98, P = .036) and ADT (HR:0.91, 95% CI 0.86-0.97, P = .002) correlated with improved OS. SBRT was not associated with improved OS versus MFRT.

conclusionSBRT, which offers a cheaper and shorter treatment course that mitigates COVID-19 exposure, was associated with improved OS versus CFRT for UIR-PCa. These results confirm guideline-based recommendations that SBRT is a viable option for UIR prostate cancer. The results from this large retrospective study require further validation in clinical trials.

Indexed as

COVID-19Prostatic NeoplasmsRadiosurgeryAndrogen AntagonistsHumansMaleRetrospective StudiesSurvival AnalysisAndrogen AntagonistsExternal beam radiation therapy, Stereotactic body radiation therapy, Hypofractionated radiotherapy, Ultra-hypofractionated radiotherapyNational Cancer DatabaseUnfavorable intermediate-risk

Identifiers

PMID35086762
PMCPMC9169574
OpenAlexW3215043486

What OpenQuestion holds

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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.