Higher-Than-Conventional Radiation Doses in Localized Prostate Cancer Treatment: A Meta-analysis of Randomized, Controlled Trials Gustavo Arruda Viani,

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Higher-Than-Conventional Radiation Doses in Localized Prostate Cancer Treatment: A Meta-analysis of Randomized, Controlled Trials Gustavo Arruda Viani, M.D., Eduardo Jose Stefano, M.D., Sergio Luis Afonso, M.D. International Journal of Radiation Oncology • Biology • Physics Volume 74, Issue 5, Pages 1405-1418 (August 2009) DOI: 10.1016/j.ijrobp.2008.10.091 Copyright © 2009 Elsevier Inc. Terms and Conditions

Fig. 1 Flowchart according to Quality of Reporting of Meta-analyses criteria. International Journal of Radiation Oncology • Biology • Physics 2009 74, 1405-1418DOI: (10.1016/j.ijrobp.2008.10.091) Copyright © 2009 Elsevier Inc. Terms and Conditions

Fig. 2 Meta-analysis regarding biochemical failure for all subgroups. CI = confidence interval. International Journal of Radiation Oncology • Biology • Physics 2009 74, 1405-1418DOI: (10.1016/j.ijrobp.2008.10.091) Copyright © 2009 Elsevier Inc. Terms and Conditions

Fig. 3 Meta-analysis regarding biochemical failure for the low-risk group. CI = confidence interval. CI = confidence interval. International Journal of Radiation Oncology • Biology • Physics 2009 74, 1405-1418DOI: (10.1016/j.ijrobp.2008.10.091) Copyright © 2009 Elsevier Inc. Terms and Conditions

Fig. 4 Meta-analysis regarding biochemical failure for the intermediate-risk group. CI = confidence interval. International Journal of Radiation Oncology • Biology • Physics 2009 74, 1405-1418DOI: (10.1016/j.ijrobp.2008.10.091) Copyright © 2009 Elsevier Inc. Terms and Conditions

Fig. 5 Meta-analysis regarding biochemical failure for the high-risk group. CI = confidence interval. International Journal of Radiation Oncology • Biology • Physics 2009 74, 1405-1418DOI: (10.1016/j.ijrobp.2008.10.091) Copyright © 2009 Elsevier Inc. Terms and Conditions

Fig. 6 Meta-analysis regarding mortality rate. CI = confidence interval. International Journal of Radiation Oncology • Biology • Physics 2009 74, 1405-1418DOI: (10.1016/j.ijrobp.2008.10.091) Copyright © 2009 Elsevier Inc. Terms and Conditions

Fig. 7 Meta-analysis regarding prostate cancer–specific mortality. CI = confidence interval. International Journal of Radiation Oncology • Biology • Physics 2009 74, 1405-1418DOI: (10.1016/j.ijrobp.2008.10.091) Copyright © 2009 Elsevier Inc. Terms and Conditions

Fig. 8 Gastrointestinal toxicity of Grade ≥2 in the trials comparing high-dose radiotherapy with conventional-dose radiotherapy. CI = confidence interval. International Journal of Radiation Oncology • Biology • Physics 2009 74, 1405-1418DOI: (10.1016/j.ijrobp.2008.10.091) Copyright © 2009 Elsevier Inc. Terms and Conditions

Fig. 9 Genitourinary toxicity of Grade ≥2 in the trials comparing comparing high-dose radiotherapy with conventional-dose radiotherapy. CI = confidence interval. International Journal of Radiation Oncology • Biology • Physics 2009 74, 1405-1418DOI: (10.1016/j.ijrobp.2008.10.091) Copyright © 2009 Elsevier Inc. Terms and Conditions

Fig. 10 Meta-regression analysis for biochemical control as a function of the radiotherapy total dose for all subgroups present in six trials. RTTD = radiotherapy total dose. International Journal of Radiation Oncology • Biology • Physics 2009 74, 1405-1418DOI: (10.1016/j.ijrobp.2008.10.091) Copyright © 2009 Elsevier Inc. Terms and Conditions

Fig. 11 Meta-regression analysis for biochemical control as a function of the radiotherapy total dose for the low-risk group present in four trials. RTTD = radiotherapy total dose. International Journal of Radiation Oncology • Biology • Physics 2009 74, 1405-1418DOI: (10.1016/j.ijrobp.2008.10.091) Copyright © 2009 Elsevier Inc. Terms and Conditions

Fig. 12 Meta-regression analysis for biochemical control as a function of the radiotherapy total dose for the intermediate-risk group present in five trials. RTTD = radiotherapy total dose. International Journal of Radiation Oncology • Biology • Physics 2009 74, 1405-1418DOI: (10.1016/j.ijrobp.2008.10.091) Copyright © 2009 Elsevier Inc. Terms and Conditions

Fig. 13 Meta-regression analysis for biochemical control as a function of the radiotherapy total dose for the high-risk group present in five trials. RTTD = radiotherapy total dose. International Journal of Radiation Oncology • Biology • Physics 2009 74, 1405-1418DOI: (10.1016/j.ijrobp.2008.10.091) Copyright © 2009 Elsevier Inc. Terms and Conditions

Fig. 14 Funnel plot to evaluate publication bias. International Journal of Radiation Oncology • Biology • Physics 2009 74, 1405-1418DOI: (10.1016/j.ijrobp.2008.10.091) Copyright © 2009 Elsevier Inc. Terms and Conditions