Brachytherapy superior to active surveillance in reducing risk of death

Patients with localized prostate cancer halve their risk of dying from the disease within 6 months of diagnosis when they undergo brachytherapy to treat their cancer rather than managing their disease through active surveillance, according to a study presented at the American Society for Therapeutic Radiology and Oncology annual meeting in Los Angeles.

The study may be used to improve the selection of appropriate treatments, since no single method of prostate cancer treatment has been shown to be clearly optimal for men diagnosed with localized disease.

“This is the first time that a population-based cohort study has compared brachytherapy to watchful waiting/active surveillance in the treatment of localized prostate cancer,” said lead author Ester H. Zhou, MD, PhD, of Case Western University School of Medicine in Cleveland. “We were pleasantly surprised to find that patients who had brachytherapy in conjunction with external beam radiation therapy and/or androgen deprivation therapy had much better survival than those patients who didn’t receive active treatment, and that it was shown to be just as effective as radical prostatectomy in lengthening the lives of prostate cancer patients.”

The study included about 11,000 men 65 years of age and older who were newly diagnosed with localized prostate cancer in Ohio between 1999 and 2001. Researchers examined the group’s survival rate after 7 years to see whether they could detect a benefit among common treatments for localized prostate cancer. They concluded that active therapies were roughly similar in terms of disease-specific survival, and that all were superior to watchful waiting/active surveillance if they are initiated within 6 months of diagnosis of localized disease.