{"id":3417,"date":"2023-01-10T14:47:58","date_gmt":"2023-01-10T14:47:58","guid":{"rendered":"https:\/\/bxta.com\/?p=3417"},"modified":"2023-01-10T14:47:59","modified_gmt":"2023-01-10T14:47:59","slug":"new-research-recommends-ldr-brachytherapy-compared-to-hf-external-beam-radiotherapy-for-patients-with-an-estimated-lifespan-of-8-years","status":"publish","type":"post","link":"https:\/\/bxta.com\/nl\/new-research-recommends-ldr-brachytherapy-compared-to-hf-external-beam-radiotherapy-for-patients-with-an-estimated-lifespan-of-8-years\/","title":{"rendered":"New Research Recommends LDR Brachytherapy Compared to HF External Beam Radiotherapy for Patients with an Estimated Lifespan of >8 Years"},"content":{"rendered":"<p><\/p>\n\n\n\n<p>A <a href=\"https:\/\/www.brachyjournal.com\/article\/S1538-4721(22)00319-1\/fulltext?dgcid=raven_jbs_aip_email#%20\"><em><strong>new study<\/strong><\/em><\/a> published in December 2022, authored by <em>Noelia Sanmamed, Lisa Joseph, Juanita Crook, Tim Craig, Padraig Warde, Anne Di Tomasso, Peter Chung, Alejandro Berlin, Andrew Bayley, Elantholi P Saibishkumar, Rachel Glicksman, Srinivas Raman, Charles Catton and Joelle Helou<\/em>, has compared the long-term oncologic outcomes of intermediate-risk (IR) prostate cancer patients (PCa) treated with low dose-rate brachytherapy (LDR-BT) versus those treated with moderate hypofractionated external beam radiotherapy (HF-EBRT).<br><br><\/p>\n\n\n\n<p>Factors that are compared include the biochemical disease-free survival (bDFS) in patients treated with LDR-BT or HF-ERBT, as well as the PSA (Prostate Specific Antigen) nadir (defined as the lowest PSA achieved after the treatment) at 4 years; distant metastases; prostate cancer-specific survival (PCSS) and overall survival (OS).<br><br><\/p>\n\n\n\n<p>Patients with intermediate-risk localised prostate cancer have several choices to make among curative-intent treatments, such as radical prostatectomy, external beam radiotherapy (EBRT) and LDR brachytherapy.<br><br><\/p>\n\n\n\n<p>Previous studies have found that LDR-BT reports long-term bDFS, with rates over 90%. On the other hand, HF-EBRT is thought to enhance biological effectiveness, thus offering a non-invasive method of dose escalation, with a promise of more convenience.<br><br><\/p>\n\n\n\n<p>Observational data has previously suggested a higher biochemical disease-free survival rate in patients treated with LDR-BT compared to standard fractionated EBRT. However, before this study, there was no published data comparing moderately HF-EBRT to LDR-BT \u2013 with treatment choice being based on patient preference, physician expertise and treatment availability.<br><br><\/p>\n\n\n\n<p>The research included patients who were diagnosed with intermediate-risk prostate cancer and treated with either LDR-BT or HF-EBRT between January 2005 and December 2013. Overall, 246 patients with IR PCa were treated, 122 patients with LDR-BT and 124 with HF-EBRT. Within the study, the Kaplan-Meier (KM) method was used to estimate OS and PCSS, and a log-rank test was used to compare treatment groups. Furthermore, a 2-tailed p-value &lt;0.05 was considered statistically significant.<br><br><\/p>\n\n\n\n<p>The results found that patients in the HF-EBRT cohort had a higher ISUP (International Society of Urologic Pathologists) grade, with 28% and 11% of patients presenting with ISUP grade 3 in HF-EBRT and LDR-BT respectively.<br><br><\/p>\n\n\n\n<p>Additionally, the median PSA nadir was 0.05 ng\/ML for LDR-BT and 0.33ng\/ML for HF-EBRT. Furthermore, the median PSA at 4 years was 0.09ng\/ML and 0.52ng\/ML respectively.<br><br><\/p>\n\n\n\n<p>A biochemical recurrence was observed in 5 patients treated with LDR-BT and 34 treated with HF-EBRT. At 60 and 90 months, the cumulative index function (CIF) of BR was 0.9% and 3.5% in the LDR-BT group vs. 16.6% and 23.7% in the HF-EBRT group, respectively.<br><br><\/p>\n\n\n\n<p>2 patients treated with LR-BT developed metastases, versus 12 treated with HF-EBRT, in which all had UIR disease. At 90 and 108 months, the CIF of metastases was 0% and 1.6% in the LDR-BT group compared to 3.4% and 9.1% in the HF-EBRT group.<br><br><\/p>\n\n\n\n<p>4 and 22 patients were treated with salvage intent in the LDR-BT and HF-EBRT cohorts respectively. In the LDR-BT group, salvage treatment consisted of ADT (hormone therapy), lymph node dissection and high-intensity focused ultrasound, whereas in the HF-EBRT group, 16 patients received ADT, 5 were treated with BT (brachytherapy), and 1 underwent HIFU (High-Intensity Focused Ultrasound)<br><br><\/p>\n\n\n\n<p>At the last follow-up, 24 patients were deceased in the entire cohort; 15 in the HF-EBRT group and 9 in the LDR-BT group. Prostate cancer was the leading cause of death in 3 of 10 patients in the HF-EBRT group, compared to 0 in the LDR-BT group.<br><br><\/p>\n\n\n\n<p>In conclusion, LDR-BT was associated with higher biochemical and metastases control in the cohort when compared to moderately HF-EBRT. The research found that in the absence of a randomised trial, LDR-BT, when feasible, should be offered to younger patients with a life expectancy of >8 years.<br><br><\/p>\n\n\n\n<p>Saheed Rashid, managing director, BXTA adds: \u201cThis study unequivocally refutes prior thinking that HF-EBRT offers enhanced biological effectiveness. On every clinical measure, LDR brachytherapy delivers improved patient outcomes over HF-EBRT and is therefore further clinical proof that LDR-B is indeed a highly viable treatment option for intermediate-risk prostate cancer patients.\u201d<br><\/p>\n\n\n\n<p>ENDS<br><br><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p>Ref: N. Sanmamed et al. , Long-term oncologic outcomes of low dose-rate brachytherapy compared to hypofractionated external beam radiotherapy for intermediate -risk prostate cancer, Brachytherapy https:\/\/ doi.org\/ 10.1016\/ j.brachy.2022.09.159<\/p>","protected":false},"excerpt":{"rendered":"<p>A new study published in December 2022, authored by Noelia Sanmamed, Lisa Joseph, Juanita Crook, Tim Craig, Padraig Warde, Anne Di Tomasso, Peter Chung, Alejandro Berlin, Andrew Bayley, Elantholi P Saibishkumar, Rachel Glicksman, Srinivas Raman, Charles Catton and Joelle Helou, has compared the long-term oncologic outcomes of intermediate-risk (IR) prostate cancer patients (PCa) treated with [&hellip;]<\/p>\n","protected":false},"author":10,"featured_media":2534,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"template-old-blog.php","format":"standard","meta":{"_acf_changed":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[9,4,1],"tags":[],"class_list":["post-3417","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthcare-professionals","category-news","category-uncategorized"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - 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