[Intensity-modulated radiotherapy for prostate cancer]

Piatigorsky N, Ciapponi A, Alfie V, Lazo E, Pichon Riviere A, Garcia Marti S, Augustovski F, Alcaraz A, Bardach, A
Record ID 32018004429
Original Title: Radioterapia de intensidad modulada en cáncer de próstata
Authors' recommendations: Low-quality evidence suggests that intensity-modulated radiotherapy (IMRT) for prostate cancer may yield an uncertain net benefit when compared with three-dimensional conformal radiation therapy (3D-CRT). This is due to a non-statistically significant increase in overall survival and a potential decrease in the risk of hip fracture and acute gastrointestinal for overall genitourinary toxicity and a potential higher risk of erectile dysfunction. This is based, in all cases, on evidence with a high bias risk. Moderate-quality evidence suggests that IMRT for prostate cancer may yield a negative net benefit when compared to radical prostatectomy because of a higher risk of overall mortality and mortality due to prostate cancer, independent from the risk group. No evidence was found that might allow determining the net benefit of IMRT when compared to brachytherapy and active surveillance. The clinical practice guidelines from Europe, United Kingdom, United States and Argentine recommend using IMRT in patients with localized prostate cancer. The literature consulted suggests that the generalized replacement of 3D-CRT by IMRT occurred before scientific evidence was available and this was possibly related to technological advances and the understanding of pathophysiology over evidence. The health public systems from United Kingdom, Australia, United States and Brazil cover IMRT for patients with prostate cancer. In the United States, the private funders Aetna, Cigna and Anthem also cover it for this indication. In Argentina, the Unique System of Reimbursement considers IMRT as a therapeutic option for patients with localized prostate cancer. No economic evaluations carried out in Argentina were found on IMRT for prostate cancer. One economic evaluation conducted in Canada found that IMRT was not cost-effective for patients with intermediate and high-risk prostate cancer.
Project Status: Completed
Year Published: 2022
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Argentina
MeSH Terms
  • Radiotherapy
  • Prostatic Neoplasms
  • Radiotherapy, Intensity-Modulated
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: info@iecs.org.ar
Contact Email: info@iecs.org.ar
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
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