Just digging around, found this gem:
SpaceOAR Hydrogel Spacer for Reducing Radiation Toxicity During Radiotherapy for Prostate Cancer. A Systematic Review
Right off the bat, full author list:
View attachment 352188
View attachment 352190
ONLY ONE of the authors reports no direct COI with this paper. We have:
KSR Ltd employees - what is that?
Kleijnen Systematic Reviews Ltd:
View attachment 352192
Evidently, the budget is not high at KSR for web design (hopefully Boston Scientific can help them out with that).
The first author, Nigel Armstrong, is an employee of KSR and has a PhD "physiotherapy" and a Masters in Health Economics. This is notable because this review is mainly focused on the dosimetric advantages of SpaceOAR and QoL, so it doesn't appear to be his normal area. Anyway - the staff profiles are on the website.
This is some of the most incredible spin I have ever seen:
View attachment 352193
View attachment 352194
1) Odds ratios were not significant...but they "generally favored" SpaceOAR - THAT'S NOT HOW THIS WORKS
2) No significant different in toxicity for brachy
3) Again, "generally reduced"
4) Just gloss on over the higher GU tox with SpaceOAR? (correlation does not equal causation, obviously)
5) Oh let's just bury this "protons + SpaceOAR = higher Grade 1 and Grade 2 events" vs no SpaceOAR
How do they consider this "evidence", in total?
View attachment 352195
1) Literally they can only highlight the sad, conflict-laden 2015 trial with almost $1 million paid to those authors which got FDA approval
2) The advantages were "verified" in observational studies? Really?
I would encourage everyone to go look at the Figures and Tables, specifically the toxicity tables. Sure, SpaceOAR makes the DVH looks better.
You know what makes the DVH also look better? A smaller PTV margin.