Inger N, Dahl O, Heikkila R, Hoisaeter PA, Bjerklund Johansen TE, Olsen DR, Klepp O, Waehre H; International Society of Technology Assessment in Health Care. Meeting.
Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 2002; 18: abstract no. 146.
The Norwegian Centre for Health Technology Assessement, Forskningsveien 1, Oslo, Norway, inger.norderhaug@unimed.sint.no
BACKGROUND/OBJECTIVES: Current treatment options for early prostate cancer (radical prostatectomy or external beam radiotherapy) have so far not increased survival for patients. Both treatment modalities carries significant side effects (impotence and incontinence). The introduction of brachyterapi (internal radiation) has improved targeting of the radiation dose to the prostate and may reduce radiation side effects on adjacent normal tissue. To assess the clinical effectiveness of brachytherapy an expert group reviewed current evidence. METHODS: Literature was identified by searches in the HTA-database, Medline and Embase. Ongoing studies were identified from Current Controlled Trials, National Cancer Institute and National Research Register. Each study was independently reviewed by three reviewers. Studies that compared brachyterapi with radical prostatectomy or external beam radiotherapy were included. Clinical outcome measurers were graded higher than biochemical outcome (PSA). Case series and studies confounded by selection bias were excluded from the final evidence. RESULTS: No randomised controlled trial was identified. Results from observational studies were often confounded by selection bias. A summary of the evidence from the 7 studies with acceptably matched groups is given below: Total or disease specific survival: No studies had acceptable long follow up (>5-10 years). Disease recurrence: No difference in time to PSA progression between the treatment modalities. Complication: Complications and complication rates seen after brachytherapy are comparable to those seen after external beam radiotherapy. Quality of life: Studies did not allow conclusions. DISCUSSION: The evidence on the clinical effectiveness of brachytherapy is scarce. Moreover no new evidence from randomised controlled trials may be expected in the near future which may aid decisions on the use of brachytherapy.
Publication Types:
Keywords:
- Adenocarcinoma
- Brachytherapy
- Carcinoma
- Case-Control Studies
- Humans
- Male
- Prostate-Specific Antigen
- Prostatectomy
- Prostatic Neoplasms
- Radiotherapy Dosage
- Radiotherapy, Conformal
- Treatment Failure
- United States
- immunology
- radiotherapy
- surgery
- hsrmtgs
Other ID:
UI: 102274762
From Meeting Abstracts