Brachytherapy Lowers Prostate Cancer Mortality

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Main Category: Prostate / Prostate Cancer
Article Date: 27 Jan 2012 - 10:00 PST

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According to a study from radiation oncologists at the Kimmel Cancer Center at Jefferson, high-risk prostate cancer patients who receive brachytherapy, alone or together with external beam radiation therapy (EBRT) had considerably lower mortality rates. The study is published online January 23 in the International Journal of Radiation Oncology*Biology*Physics.

Brachytherapy is a form of radiotherapy where a radiation source is placed directly at the site of a tumor. The treatment is generally used to treat men with low and intermediate risk prostate cancers.

The procedure is less common and controversial in men with high-risk prostate cancer, partly due to results from prior studies suggesting that the treatment is associated with lower cure rates than EBRT.

According to many experts, these earlier studies were limited by poor brachytherapy technique, and they believe that high-quality contemporary brachytherapy could be an effective tool to treat individuals with high-risk prostate cancer.

Co-author Timothy Showalter, M.D., assistant professor in the Department of Radiation Oncology at Thomas Jefferson University Hospital, and associate research member of Jefferson's Kimmel Cancer Center, explains:

"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. Although studies like this cannot prove an advantage of 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."

The team identified 12,745 men diagnosed with high-grade prostate cancer of poorly differentiated grade from 1988 to 2002, using the Surveillance, Epidemiology, and End Results database:

• 7.1% of the patients received brachytherapy
• 73.5% received EBRT alone
• 19.1% received brachyherapy in combination with EBRT

The researchers used multivariate models to analyze patient and tumor characteristics connected with the chances of treatment with each radiation modality, in addition to the effect of radiation modality on prostate cancer-specific mortality.

The researchers found that treatment with brachytherapy, alone or in combination with EBRT, was linked to considerable reduction in prostate-related mortality rates than EBRT alone.

Significant predictors of use of brachytherapy, alone or in combination with EBRT were later year of diagnosis, urban resistance, earlier T-stage, and younger age.

Lead research Xinglei Shen, M.D., a resident in the Jefferson's Department of Radiation Oncology and a part-time master's degree student in the Jefferson School of Population health, and colleagues explained that the findings supply enough evidence to continue investigation brachytherapy as part of an effective treatment strategy for patients with high-risk prostate cancer.

Dr. Shen explained:

"Today, for the most part, brachytherapy is not being used for these high-risk patients or even recommended. But if you look at the biology and theory behind it, it makes sense: you can really give a lot more dose with brachytherapy than with EBRT alone to the prostate. And this presents an opportunity for high-risk patients."

Written by Grace Rattue
Copyright: Medical News Today
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