Brachytherapy: Aggressive Prostate Cancer May Be Under-Treated
In the first and only study designed to compare a single prostate cancer treatment, brachytherapy, to a combination of treatment methods for differences in mortality rates in men with high-risk prostate cancer, researchers at Brigham and Women's Hospital (BWH) have found that a single treatment method of brachytherapy, also called seed therapy, alone is associated with higher death rates from prostate cancer. This research is published online and in an upcoming print edition of the Journal of Clinical Oncology.
"Despite the increasing numbers of men worldwide who choose to undergo brachytherapy alone for their high-risk, prostate cancer, the evidence supporting this treatment method alone based on survival data from randomized trials is lacking" said Anthony D'Amico, MD, PhD, lead researcher and chief of genitourinary radiation oncology at BWH."In order to get the highest cure rate for men with high risk prostate cancer, it appears that five weeks of external beam radiation and at least four months of hormonal therapy should be added to brachytherapy."
To address the difference in mortality rates, researchers evaluated the difference in the risk of death from prostate cancer in 1,342 men with high-risk cancer and at least a 10-year life expectancy. Participants were treated at one of 21 community- based medical centers in the United States using brachytherapy alone or in conjunction with hormone therapy (androgen suppression therapy), external beam radiation therapy or both. High-risk cancer was defined as having cancer felt beyond the prostate capsule on exam or having a prostate-specific antigen level over 20 or Gleason score between eight and 10 inclusive.
The study disclosed that despite a higher baseline risk of death from prostate cancer, men who underwent a combination therapy of brachytherapy, hormone therapy and external beam radiation had a lower risk of death from prostate cancer after treatment when compared to men who brachytherapy alone or the combination of external beam radiation and had brachytheapy or hormonal therapy and brachytherapy.