Brachytherapy’s Benefits Remain Uncertain

Brachytherapy’s Benefits Remain Uncertain

No new evidence yet shows the advantages of interstitial brachytherapy over other forms of treatment in men with localized prostate cancer, even though 20 new studies have been released, according to a report released today by the Institute for Quality and Efficiency in Health Care (IQWiG), a German independent scientific institute that investigates the benefits and harms of medical interventions. IQWiG, therefore, has not changed its conclusions from its 2007 report.

Although the new studies included a randomized controlled trial, the institute found the evidence to be insufficient to determine brachytherapy’s advantages. The report notes that some studies showed deficiencies making the result difficult to interpret and other studies did not enroll enough participants or follow them long enough making the results lack quality data for comparison.

IQWiG found that no robust conclusions on disease-free survival can be made because prostate specific antigen–based recurrence-free survival was often used as an outcome measure, but this measure is not designed as a surrogate for comparison between treatments.

Brachytherapy may, however, confer advantages. For example, IQWiG found that, when compared with prostatectomy, brachytherapy may result in less impairment of sexual function and a lower rate of urinary incontinence. In addition, when compared with external beam radiotherapy, brachtherapy may result in less impairment in bowel function.

Disadvantages were also found in the new studies. When compared with proatatectomy, brachtherapy more strongly impaired various voiding disorders.

To help close these gaps in knowledge, a large-scale, randomized controlled trial will compare brachytherapy with prostatectomy, external beam radiation, and active surveillance where appropriate. The trial is set to begin this year.

Brachytherapy’s Benefits Remain Uncertain

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