New original research from Leeds Teaching Hospitals NHS Trust, as published in Elsevier’s Journal of Clinical and Translational Radiation Oncology, has revealed that men with intermediate- and high-risk prostate cancer treated with a low dose rate brachytherapy boost in combination with external beam radiotherapy (LDR-EBRT) achieve more effective PSA control over a five year post-treatment period than men treated with a high dose rate brachytherapy boost (HDR-EBRT).
Dose escalation has been shown to result in improved biochemical progression free survival (bPFS) - or improved PSA control - in localised prostate cancer. Dose escalation can be delivered in multiple ways: through external beam radiotherapy (EBRT) alone; through brachytherapy; and through a combination of both therapies. Several studies of patients with intermediate and high risk prostate cancer have reported improved bPFS for both high dose rate brachytherapy in combination with EBRT (HDR–EBRT) and low dose rate permanent seed brachytherapy in combination with EBRT (LDR–EBRT) when compared to EBRT alone. However, there has been a lack of evidence directly comparing LDR–EBRT with HDR–EBRT.
The Leeds study compared the outcomes of 116 men treated with LDR-EBRT and 171 treated with HDR–EBRT between 1996 - 2007, and 2007 – 2012 respectively. It found that patients treated with HDR–EBRT were more than twice as likely to experience biochemical progression – elevated PSA - compared with LDR–EBRT, meaning that patients treated with LDR-EBRT were more likely to have better disease control.
PSA is an important predictor of long term bPFS in men treated with prostate cancer and a lower PSA level is associated with a better outcome.
With diagnoses of prostate cancer on the increase and significant investment in both diagnosis and treatment of prostate cancer, it is important than ever that men diagnosed ensure they research and seek advice on all available treatment options as well as overall and progression free survival rates.