Authors' objectives:

To assess the efficacy, safety in use, technique and economic aspects of 3D conformal radiotherapy (3D-CRT).

Authors' results and conclusions: (i) Definition: 3D-CRT covers a number of different technologies, as there is not yet any consensus on a single definition. It is a complex technique, with problems and uncertainties throughout the process; rigorous and specific quality assurance is required. (ii) Efficacy and safety of 3D-CRT in cancer of the prostate: None of the 26 trials selected were of good quality. None measured the efficacy of 3D-CRT. Limited data derived from trials of an intermediate level of evidence demonstrated improved local control of cancer of the prostate, with no impact on survival after 5 years of follow-up, when using higher radiation doses than for conventional radiotherapy (CR). Comparison of tolerance of 3D-CRT and CR showed: - for the same radiation dose: Early tolerance and late gastrointestinal toxicity were improved with 3D-CRT, with no change in late urinary tolerance; - for radiation doses higher than the standard dose: Early tolerance of 3D-CRT was similar to that of standard radiation, but late gastrointestinal toxicity was increased. (iii) Other sites (cancers of the head and neck, and of the central nervous system): Only the feasibility of the technique has been demonstrated.

Authors' recommendations: (i) More extensive use of 3D-CRT will require quality assurance guidelines and the introduction of specific training. (ii) Further clinical trials are needed, in particular to assess the impact of the higher doses made possible by 3D-CRT. (iii) Most importantly, the place of 3D-CRT should be established as part of a global assessment of cancer treatment, and for each organ specifically.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.has-sante.fr/

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: France

Organisation Name: L'Agence Nationale d'Accreditation d'Evaluation en Santé

Contact Address: 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France. Tel: +33 01 55 93 71 88; Fax: +33 01 55 93 74 35;

Contact Name: sh.leerobin@has-sante.fr

Contact Email: sh.leerobin@has-sante.fr

Copyright: L'Agence Nationale d'Accreditation d'Evaluation en Sante (ANAES)