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Salvage therapies for biochemical recurrence after definitive local treatment: a systematic review, meta-analysis, and network meta-analysis
A. Matsukawa, T. Yanagisawa, T. Fazekas, M. Miszczyk, I. Tsuboi, M. Kardoust Parizi, E. Laukhtina, J. Klemm, S. Mancon, K. Mori, S. Kimura, J. Miki, J. Gomez Rivas, TFW. Soeterik, T. Zilli, D. Tilki, S. Joniau, T. Kimura, SF. Shariat, P. Rajwa
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články, metaanalýza, síťová metaanalýza, systematický přehled
NLK
ProQuest Central
od 1997-09-01 do Před 1 rokem
Open Access Digital Library
od 1997-01-01
Health & Medicine (ProQuest)
od 1997-09-01 do Před 1 rokem
Public Health Database (ProQuest)
od 2024-01-01 do Před 1 rokem
- MeSH
- lidé MeSH
- lokální recidiva nádoru * terapie patologie krev MeSH
- nádory prostaty * terapie patologie mortalita krev MeSH
- prostatektomie MeSH
- prostatický specifický antigen krev MeSH
- randomizované kontrolované studie jako téma MeSH
- záchranná terapie * metody MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- síťová metaanalýza MeSH
- systematický přehled MeSH
PURPOSE: Recent advancements in the management of biochemical recurrence (BCR) following local treatment for prostate cancer (PCa), including the use of androgen receptor signaling inhibitors (ARSIs), have broadened the spectrum of therapeutic options. We aimed to compare salvage therapies in patients with BCR after definitive local treatment for clinically non-metastatic PCa with curative intent. METHODS: In October 2023, we queried PubMed, Scopus, and Web of Science databases to identify randomized controlled trials (RCTs) and prospective studies reporting data on the efficacy of salvage therapies in PCa patients with BCR after radical prostatectomy (RP) or radiation therapy (RT). The primary endpoint was metastatic-free survival (MFS), and secondary endpoints included progression-free survival (PFS) and overall survival (OS). RESULTS: We included 19 studies (n = 9117); six trials analyzed RT-based strategies following RP, ten trials analyzed hormone-based strategies following RP ± RT or RT alone, and three trials analyzed other agents. In a pairwise meta-analysis, adding hormone therapy to salvage RT significantly improved MFS (HR: 0.69, 95% CI: 0.57-0.84, p < 0.001) compared to RT alone. Based on treatment ranking analysis, among RT-based strategies, the addition of elective nodal RT and androgen deprivation therapy (ADT) was found to be the most effective in terms of MFS. On the other hand, among hormone-based strategies, enzalutamide + ADT showed the greatest benefit for both MFS and OS. CONCLUSIONS: The combination of prostate bed RT, elective pelvic irradiation, and ADT is the preferred treatment for eligible patients with post-RP BCR based on our analysis. In remaining patients, or in case of post-RT recurrence, especially for those with high-risk BCR, the combination of ADT and ARSI should be considered.
Centre for Translational Medicine Semmelweis University Budapest Hungary
Collegium Medicum Faculty of Medicine WSB University Dąbrowa Górnicza Poland
Department of Biomedical Sciences Humanitas University Pieve Emanuele Italy
Department of Development and regeneration KU Leuven Leuven Belgium
Department of Radiation Oncology University Medical Center Utrecht Utrecht The Netherlands
Department of Urology 2nd Faculty of Medicine Charles University Prague Czechia
Department of Urology Clinico San Carlos Hospital Madrid Spain
Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria
Department of Urology Faculty of Medicine Shimane University Shimane Japan
Department of Urology Koc University Hospital Istanbul Turkey
Department of Urology Medical University of Silesia Zabrze Poland
Department of Urology Semmelweis University Budapest Hungary
Department of Urology Shariati Hospital Tehran University of Medical Science Tehran Iran
Department of Urology St Antonius Hospital Utrecht The Netherlands
Department of Urology The Jikei University School of Medicine Tokyo Japan
Department of Urology University Hospitals Leuven Leuven Belgium
Department of Urology University Medical Center Hamburg Eppendorf Hamburg Germany
Department of Urology University of Texas Southwestern Medical Center Dallas TX USA
Department of Urology Weill Cornell Medical College New York NY USA
Division of Urology Department of Special Surgery The University of Jordan Amman Jordan
Faculty of Medicine University of Geneva Geneva Switzerland
Institute for Urology and Reproductive Health Sechenov University Moscow Russia
Karl Landsteiner Institute of Urology and Andrology Vienna Austria
Martini Klinik Prostate Cancer Center University Hospital Hamburg Eppendorf Hamburg Germany
Citace poskytuje Crossref.org
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