This study compared the outcome of low-dose rate brachytherapy (LDR-BT) and image-guided intensity-modulated radiotherapy (IG-IMRT) for localized prostate cancer of different severities. With/ without External Beam RadioTherapy. Five year survival rates were almost the same for both treatments. Five year biochemical failure free survival rates higher for patients treated with LDR-BT compared to IG-IMRT.
However, significant failure free survival rates were only seen in the high risk group (94.9% for LDR-BT versus 85.1% for IG-IMRT). Inverse probability of treatment weighting (IPTW) involving propensity scores was used to reduce background selection bias. Analysis showed that IG-IMRT had higher levels of gastrointestinal toxicity, but lower levels of genitourinary toxicity compared to LDR-BT.
Overall, control of PSA levels were similar between LDR-BT and IG-IMRT treatments in low to intermediate risk groups, but LDR-BT showed more of an ability to control PSA levels in high risk patients.
Research link: https://www.ncbi.nlm.nih.gov/pubmed/30002393
