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Meta-Analysis
. 2023;31(S1):357-372.
doi: 10.3233/THC-236031.

Comparison of chronic gastrointestinal and genitourinary toxicities between brachytherapy and external beam radiotherapy for patients with prostate cancer: A systematic review and meta-analysis

Xuanzhe Li  1   1 , Ligang Shan  2   1 , Qianqi Wang  3 , Huige Zhai  3 , Yinghua Xuan  4 , Gen Yan  3
Affiliations
Meta-Analysis

Comparison of chronic gastrointestinal and genitourinary toxicities between brachytherapy and external beam radiotherapy for patients with prostate cancer: A systematic review and meta-analysis

Xuanzhe Li et al. Technol Health Care. 2023.

Abstract

Background: 125I BT is an effective radiotherapy for prostate cancer. However, comparison data of GI and GU toxicities between BT, BT + EBRT, and EBRT-alone patient groups is limited.

Objective: To define the GI and GU toxicities in prostate cancer to prevent adverse events after treatment.

Methods: We searched published studies in PubMed, Cochrane, and Embase databases up to December 31, 2022. The endpoints were the RRs of GI and GU toxicities. Pooled data were assessed using a random-effects model.

Results: Fifteen eligible studies were included into this analysis. LDR-BT had significantly lower RRs than LDR-BT + EBRT for acute GI (2.13; 95% CI, 1.22-3.69; P= 0.007) and late GI toxicities (3.96; 95% CI, 1.23-12.70; P= 0.02). Moreover, EBRT had significantly higher RRs than LDR-BT for acute GU (2.32; 95% CI, 1.29-4.15; P= 0.005) and late GU toxicities (2.38; 95% CI, 1.27-4.44; P= 0.007). HDR-BT had significantly higher RRs for acute GU toxicities than LDR-BT alone (0.30; 95% CI, 0.23-0.40; P< 0.00001).

Conclusion: The results implied that BT with and without EBRT can result in both GI and GU toxicities in patients with prostate cancer, with LDR-BT leading to a poorer urinary function than EBRT.

Keywords: Prostate cancer; brachytherapy; external beam radiotherapy; gastrointestinal; genitourinary; meta-analysis.

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Conflict of interest statement

None to report.

Figures

Figure 1.
Figure 1.
Study selection. Flow diagram summarising selection of studies that meet inclusion criteria.
Figure 2.
Figure 2.
(a) Forest plot of RR for acute GI toxicity following LDR-BT + EBRT and LDR-BT. (b) Forest plot of RR for late GI toxicity following LDR-BT + EBRT and LDR-BT.
Figure 3.
Figure 3.
(a) Forest plot of RR for acute GU toxicity following LDR-BT + EBRT and LDR-BT. (b) Forest plot of RR for late GU toxicity following LDR-BT + EBRT and LDR-BT.
Figure 4.
Figure 4.
(a) Forest plot of RR for acute GI toxicity following LDR-BT and EBRT. (b) Forest plot of RR for late GI toxicity following LDR-BT and EBRT.
Figure 5.
Figure 5.
(a) Forest plot of RR for acute GU toxicity following LDR-BT and EBRT. (b) Forest plot of RR for late GU toxicity following LDR-BT and EBRT.
Figure 6.
Figure 6.
(a) Forest plot of RR for acute GI toxicity following HDR-BT and LDR-BT. (b) Forest plot of RR for acute GU toxicity following HDR-BT and LDR-B.
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