Brachytherapy reduces death in high-risk PCa patients

Brachytherapy alone, or in combination with external beam radiation therapy (EBRT), significantly reduces mortality rates in patients with high-risk prostate cancer, report the authors of a study from Thomas Jefferson University, Philadelphia.

"The study contradicts traditional policies of using brachytherapy in just low- and intermediate-risk patients by suggesting there may instead be an improvement in prostate cancer survival for high-risk patients," said co-author Timothy Showalter, MD. "Although studies like this cannot prove an advantage for brachytherapy, our report does suggest that brachytherapy is no less effective than EBRT and should be considered for some men with high-risk prostate cancer."

Results were published online in the International Journal of Radiation Oncology*Biology*Physics (Jan. 21, 2012).

The authors identified 12,745 Surveillance, Epidemiology, and End Results database patients diagnosed from 1988 to 2002 with high-grade prostate cancer of poorly differentiated grade and treated with brachytherapy (7.1%), EBRT alone (73.5%), or brachytherapy plus EBRT (19.1%). The team used multivariate models to examine patient and tumor characteristics associated with the likelihood of treatment with each radiation modality and the effect of radiation modality on prostate cancer-specific mortality.

Treatment with brachytherapy alone (HR, 0.66; 95% CI, 0.49-0.86) or brachytherapy in combination with EBRT (HR, 0.77; 95% CI, 0.66-0.90) was associated with significant reduction in prostate cancer-specific mortality rates compared with EBRT alone, the authors found. Significant predictors of use of brachytherapy or brachytherapy plus EBRT were younger age, later year of diagnosis, urban residence, and earlier T-stage.

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