Evidence-based guideline recommendations on low-dose rate brachytherapy in patients with low- or intermediate-risk prostate cancer

Objective: The Genitourinary Cancer Disease Site Group (GUDSG) and Cancer Care Ontario’s Program in Evidence-Based Care (PEBC) in Ontario, Canada developed a guideline on low-dose rate brachytherapy (LDR-BT) in patients with early-stage low-grade prostate cancer in 2001. The current updated guideline focuses on the research questions regarding the effect of LDR-BT alone, the effect of LDR-BT with external beam radiation therapy (EBRT) and the selection of an isotope.Methods: This guideline was developed by using the methods of the Practice Guidelines Development Cycle and the core methodology was a systematic review. MEDLINE and EMBASE (from January 1996 to October 2011), the Cochrane Library, main guideline websites, and main annual meeting abstract websites specific for genitourinary diseases were searched. Internal and external reviews of the draft guideline were conducted.Results: The draft guideline was developed according to a total of 10 systematic reviews and 55 full text articles that met the preplanned study selection criteria. The quality of evidence was low to moderate. The final report reflects integration of the feedback obtained through the internal review (two oncologists and a methodologist) and external review (five target reviewers and 48 professional consultation reviewers) process, with final approval given by the GU DSG and the PEBC.Conclusion: The main recommendations are: (1) For patients with newly diagnosed low-risk or intermediate-risk prostate cancer who require or choose active treatment, LDR-BT alone is a treatment option as an alternative to EBRT alone or RP alone; and (2) I-125 and Pd-103 are each reasonable isotope options.

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Low-dose rate brachytherapy for patients with low- or intermediate-risk prostate cancer: a systematic review

Canadian Urological Association Journal ◽

10.5489/cuaj.1482 ◽

2013 ◽

Vol 7 (11-12) ◽

pp. 463 ◽

Cited By ~ 14

Author(s):

George Rodrigues ◽

Xiaomei Yao ◽

Andrew D Loblaw ◽

Michael Brundage ◽

Joseph L. Chin

Keyword(s):

Prostate Cancer ◽

Systematic Review ◽

Dose Rate ◽

Low Dose ◽

External Beam Radiation ◽

Current Evidence ◽

Intermediate Risk ◽

Low Dose Rate ◽

Risk Prostate Cancer ◽

Low Dose Rate Brachytherapy

Introduction: We review the current evidence for the role of low-dose rate brachytherapy (PB) in patients with low- or intermediate-risk prostate cancer using a systematic review of the literature.Methods: We searched MEDLINE and EMBASE (from January 1996to October 2011), the Cochrane Library, relevant guideline websites, and websites for meetings specific for genitourinary diseases.Results: Ten systematic reviews and 55 single-study papers met the pre-planned study selection criteria. In the end, 36 articles were abstracted and analyzed for this systematic review. There is no evidence for a difference in efficacy between PB and external beam radiation therapy (EBRT), or between PB and radical prostatectomy (RP). During the 6 months to 3 years after treatment, PB was associated with less urinary incontinence and sexual impotency than RP, and RP was associated with less urinary irritation and rectal morbidity than PB. However, these differences diminished overtime. PB conferred less risk of impotency and rectal morbidity in the 3 years after treatment than EBRT. Iodine-125 and alladium-103 did not differ with respect to biochemical relapse-free survival and patient-reported outcomes.Conclusions: PB alone is a treatment option with equal efficacyto EBRT or RP alone in patients with newly diagnosed low- or intermediate-risk prostate cancer who require or choose active treatment.

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Low-dose rate brachytherapy for patients with low or intermediate-risk prostate cancer. Analysis of relapse-free survival

Experimental and Сlinical Urology ◽

10.29188/2222-8543-2019-11-2-44-49 ◽

2019 ◽

Vol 11 (2) ◽

pp. 44-49

Author(s):

V.A. Solodky ◽

◽

A.Yu. Pavlov ◽

A.D. Tsybulskiy ◽

A.S. Pchelintsev ◽

...

Keyword(s):

Prostate Cancer ◽

Dose Rate ◽

Low Dose ◽

Intermediate Risk ◽

Relapse Free Survival ◽

Free Survival ◽

Low Dose Rate ◽

Risk Prostate Cancer ◽

Low Dose Rate Brachytherapy

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Population-based 10-year oncologic outcomes after low-dose-rate brachytherapy for low-risk and intermediate-risk prostate cancer

Cancer ◽

10.1002/cncr.27911 ◽

2012 ◽

Vol 119 (8) ◽

pp. 1537-1546 ◽

Cited By ~ 74

Author(s):

W. James Morris ◽

Mira Keyes ◽

Ingrid Spadinger ◽

Winkle Kwan ◽

Mitchell Liu ◽

...

Keyword(s):

Prostate Cancer ◽

Dose Rate ◽

Low Dose ◽

Population Based ◽

Low Risk ◽

Oncologic Outcomes ◽

Intermediate Risk ◽

Low Dose Rate ◽

Risk Prostate Cancer ◽

Low Dose Rate Brachytherapy

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Treatment outcomes of 125I low-dose-rate brachytherapy vs radical prostatectomy for patients with intermediate-risk prostate cancer

10.21203/rs.3.rs-29556/v1 ◽

2020 ◽

Author(s):

Zhien Zhou ◽

Meiting He ◽

Yi Zhou ◽

Weigang Yan ◽

Xingcheng Wu ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Dose Rate ◽

Low Dose ◽

Intermediate Risk ◽

Relapse Free Survival ◽

Free Survival ◽

Low Dose Rate ◽

Risk Prostate Cancer ◽

Low Dose Rate Brachytherapy

Abstract Background: Radical prostatectomy (RP) and low-dose-rate brachytherapy (LDR) are two widely used treatment options for patients with intermediate-risk prostate cancer (IRPC). However, which one is better remains controversial. Therefore, the purpose of this study was to compare the efficacy of RP vs LDR for patients with IRPC. Methods: A retrospective analysis was performed on 361 IRPC patients who underwent treatment from January 2010 and August 2017. 160 underwent RP and 201 underwent LDR using Iodine-125. Biochemical failure for RP was defined as prostate-specific antigen (PSA) levels > 0.2 ng/ml, and for LDR as nadir PSA level + 2 ng/ml. The log-rank test compared biochemical relapse-free survival (bRFS) between the two modalities, and Cox regression identified factors associated with bRFS. Results: Median follow-up was 54 months for RP and 69 months for LDR. The 5-and 8-year bRFS rates were 70.2% and 63.1% in the RP group, and 83.2% and 68.9% in the LDR group, respectively, P=0.003. There were no significant differences in terms of clinical relapse-free survival (cRFS), cancer-specific survival (CSS) or overall survival (OS) between the two groups. Conclusion: LDR is a reasonable treatment option for IRPC patients, yielding improved bRFS and equivalent rates of cRFS, CSS and OS compared with RP.

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