Long-term study again proves superiority of brachytherapy over surgery

For more than 20 years, LDL brachytherapy (seed implantation) has been an established treatment option for localized prostate cancer in national and international guidelines of medical societies. A recently published study has once again confirmed the excellent efficacy of brachytherapy: Ten years after treatment, the biochemical freedom from recurrence (no re-increase of PSA in the blood after therapy) was significantly better in patients who received a seed implant than in patients whose prostate had been surgically removed or those who received external radiation.

Better effectiveness of seed implantation also in the long term

In the so-called retrospective analysis, scientists at Kaiser Permanente, Los Angeles Medical Center examined about 1500 patients with a localized, medium-risk prostate carcinoma. At the time of diagnosis, the men had a tumor stage of T2b-c, a Gleason score of 7 (3 + 4 or 4 + 3) and a PSA value of 10.1-20. They were treated either by surgical removal of the prostate, external radiation or seed implantation. The results once again confirm the high effectiveness of brachytherapy: While after ten years only 52 percent of the operated men and 57 percent of the patients with external radiation were free of biochemical recurrence, the rate after seed implantation was 82 percent.

West German Prostate Centre confirms study data

"The current study is further scientific proof that brachytherapy is superior to surgery in the long term in terms of its effectiveness, even in prostate cancer patients with a medium risk profile," emphasizes Dr. Stephan Neubauer, urologist at the West German Prostate Center (WPZ). The Cologne center, which is one of the institutions with the highest case numbers in Germany and Europe, can confirm the high effectiveness of brachytherapy over the long term based on its own patient data. "Since the year 2000, we have performed more than 8,000 brachytherapies, of which 1,900 patients have been treated with permanent seed implantation alone and followed up over a period of up to 20 years", says the urologist and pioneer of brachytherapy in Germany.  

IQWIG assessment again refuted

In addition, the study once again refutes the incorrect assessment of brachytherapy by the Institute for Quality and Efficiency in Health Care (IQWiG). LINK to the report. "The evidence base for the modern form of radiotherapy is becoming increasingly clearer," says Dr Neubauer. Nevertheless, radical prostatectomy continues to be protected and complications and losses in efficacy and quality of life are accepted.

Literature:
Goy BW, Burchette R, Soper MS et al.: Ten-Year Treatment Outcomes of Radical Prostatectomy Vs External Beam Radiation Therapy Vs Brachytherapy for 1503 Patients With Intermediate-risk Prostate Cancer. Urology 020 Feb;136:180-189. doi: 10.1016/j.urology.2019.09.040. Epub 2019 Nov 5.

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