Brachytherapy, High-Dose EBRT Equal for Early Prostate Ca

SAN FRANCISCO—High-dose external beam radiation therapy (EBRT) and brachytherapy are equally effective in treating localized prostate cancer, according to a study presented at the 2006 Prostate Cancer Symposium (abstract 38). "Our findings show that either therapy is an excellent choice for treating early-stage prostate cancer," said John J. Coen, MD, assistant professor of radiation oncology at Harvard Medical School.

This case-matched analysis compared outcomes for 132 patients receiving high-dose EBRT on a recently reported randomized trial with those for 132 similar patients treated with prostate brachytherapy. All patients were treated between 1996 and 2000. The men were matched for age, Gleason score (GS), tumor stage, and initial PSA level. The Gleason score was the same for both groups (85% GS 6, 13% GS 7, 2% GS 8-10) as was the T stage (75% T1, 25% T2). Median PSA was similar for the two groups: 5.5 ng/mL (range, 0.6 to 12.1) for brachytherapy vs 6.1 ng/mL (range, 0.7 to 13.8) for EBRT. Median follow-up was 5.4 years for EBRT and 4.7 years for brachytherapy. No patients received hormonal therapy.

Biochemical no evidence of disease (bNED) by ASTRO criteria without backdating was the same in both groups at 5 years. Overall bNED was 88% and 90% for EBRT and brachytherapy, respectively (P = .70). The corresponding rates for men at low risk were 84% and 89% (P = .34), and 94% for men at intermediate risk in both groups (P = .85). There were an insufficient number of high-risk men to be included for analysis. "As the outlook appears to be similar in these patients, quality-of-life assessments may guide treatment decisions in the future," Dr. Coen concluded.