Shifting brachytherapy monotherapy case mix toward intermediate-risk prostate cancer - Abstract

PURPOSE: The relative use of brachytherapy (BT) for prostate cancer has declined in recent years.

In this setting, we sought to determine whether the case mix of BT monotherapy-treated men has changed over time in terms of risk group composition.

METHODS AND MATERIALS: The Surveillance, Epidemiology, and End Results database was used to identify 30,939 patients diagnosed with prostate adenocarcinoma between 2004 and 2011 who received BT monotherapy. The case mix of BT monotherapy patients was calculated by patient risk group and year of diagnosis.

RESULTS: Between 2004 and 2011, the use of BT monotherapy declined overall. The relative percentage of men undergoing BT with low-risk disease declined by 4.5%, whereas the relative percentage of patients with intermediate-risk disease increased by 4.7%. Non-white patients and those from poorer counties did not show shifts in the risk group makeup of BT monotherapy patients, whereas white patients and those from wealthier counties did.

CONCLUSIONS: Although fewer patients with prostate cancer are undergoing BT monotherapy, men with intermediate-risk disease comprised a significantly larger portion of the BT case mix in 2011 compared with 2004. Future research efforts by brachytherapists should be directed toward improving BT technique, optimizing radiation doses, and obtaining long-term followup data for patients with intermediate-risk prostate cancer.

Written by:
Muralidhar V, Mahal BA, Ziehr DR, Chen YW, Nezolosky MD, Viswanathan VB, Beard CJ, Devlin PM, Martin NE, Orio PF 3rd, Nguyen PL.   Are you the author?
Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School, Boston, MA; Harvard Medical School, Boston, MA; Harvard T.H. Chan School of Public Health, Boston, MA; Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA.  

Reference: Brachytherapy. 2015 Apr 14. pii: S1538-4721(15)00423-7.
doi: 10.1016/j.brachy.2015.03.004

PubMed Abstract
PMID: 25887342 Prostate Cancer Section