Brachytherapy boost in anal canal cancer – A GEC ESTRO PDR task force meta-analysis

• Published in: Clinical and translational radiation oncology 2023-03, Vol.39, p.100589-100589, Article 100589
• Main Authors: Annede, Pierre, Ferre, Marjorie, Kirisits, Christian, Pieters, Bradley R., Schmid, Maximilian, Strnad, Vratislav, Westerveld, Henrike, Chargari, Cyrus
• Format: Article
• Language: English
• Subjects: Anal cancer; Brachytherapy; High-dose rate brachytherapy; Local control; Morbidity; Original; Pulsed-dose rate brachytherapy; Toxicity
• ISSN: 2405-6308; 2405-6308
• DOI: 10.1016/j.ctro.2023.100589

•Both PDR and HDR BT provided a high efficacy and good profile tolerance.•Significant different dose levels according to the EQD2 model were used.•PDR BT still has a crucial role to increase the dose in advanced cases.•The place of HDR for large tumors and dose escalation is under investigation. A meta-analysis is presented comparing clinical outcomes and toxicities between high dose rate (HDR) and pulsed dose rate (PDR) brachytherapy (BT) for anal cancer. Retrospective or prospective clinical trials were identified on electronical databases. Data were collected per Preferred Reporting Items for Systematic Reviews and meta-Analyses guidelines. Pooled effect size for HDR and PDR BT were compared using subgroup analyses. Nine retrospective studies with a total of 481 patients treated were included of which 219 with HDR and 262 with PDR. Significant differences were observed between the two groups for baseline characteristics and treatment. The cumulative proportion of stage T3-T4 was lower in the HDR group, 0.15 [95 % confidence interval (CI) 0.07–0.29] vs 0.27 [95 %CI 0.09–0.57] in the LDR group, p