LDR Brachytherapy – Latest study indicates acceptable GU toxicity in patients with prostate cancer treated with permanent seed implantation (PI)

A new study published in the International Multidisciplinary Brachytherapy Journal entitled Genitourinary toxicity after permanent iodine-125 seed implantation: The nationwide Japanese prostate cancer outcome study of permanent iodine-125 seed implantation (J-POPS) has found that patients who underwent low dose rate brachytherapy displayed acceptable and comparable levels of genitourinary (GU) toxicity to those previously reported in U.S. patients. The findings of this study support those of the Ascende-RT trial, which was the first randomised clinical trial comparing brachytherapy to the traditional use of external beam radiation therapy to treat intermediate and high risk prostate cancer patients.
The purpose of the nationwide prospective cohort study in Japan was to evaluate acute and late genitourinary (GU) toxicity and to clarify factors associated with GU toxicity in patients with prostate cancer treated with permanent seed implantation (PI).
Of the 2,354 patients enrolled, GU toxicity was evaluated in 2,339 patients at 3, 12, 24, and 36 months after treatment. Approximately 53% of the patients treated with PI / LDR-B alone and 42% of those treated with a combination therapy of LDR-B and external beam radiation therapy showed urinary frequency / urgency at 3 months. Of all patients, 53 (2.3%) suffered from acute urinary retention, of which 49 (92.5%) recovered with a median time of 4.3 months during the follow-up period.
Studies like this and Ascende-RT – alongside other clinical studies such as that published in The Central European Journal of Urology (CEJU) in September 2018 provide an increasingly strong evidence base and information that can help clinicians and commissioners determine the best treatments to offer patients with prostate cancer.
LDR brachytherapy is a safe and effective method for the treatment of low-risk localised prostate cancer with excellent oncological outcomes with limited functional inconveniences. Moreover, it is a viable combination treatment option for men with intermediate- and higher-risk prostate cancer with minimal side-effects.
Men diagnosed with prostate cancer are entitled to knowing about all their treatment options prior to making a decision. Being both disease-free and having optimal quality of life outcomes must be key considerations.