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Benefit of LDR Brachytherapy In Patients With Early-Stage Prostate Cancer Is Still Unclear

(IQWIG [Germany]) Nov 16, 2018 - Interstitial brachytherapy uses slightly radioactive particles implanted into the prostate to deliver radiation directly to the tumour (low-dose-rate, LDR). Due to a lack of conclusive data, it still remains an unresolved issue as to whether this procedure has advantages compared with other treatments in men with localized prostate cancer.

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Howard Sandler, MD, MS, FASTRO (Posted: November 19, 2018)

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It's very challenging to run clinical trials when patients are randomized to very different treatment, such as radiation vs. surgery. LDR brachytherapy has strong data supporting its use but there are limited randomized comparisons. It has been shown to be a relatively low cost monotherapy for prostate cancer but has limited use in the US due to a learning curve and limited practitioner base with expertise. The ASCENDE RT trial suggested a benefit to LDR brachytherapy as a boost when compared to EBRT alone but this finding is somewhat controversial since the study has so far only showed a PSA benefit but not a MFS or OS benefit.

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