BROOKLYN, NY – While several prior studies have suggested that brachytherapy utilization has significantly decreased as intensity modulated radiation therapy usage has increased, a group of VA researchers sought to investigate brachytherapy utilization in a large, hospital-based registry.
For the study, conducted by VA NY Harbor Brooklyn campus researchers and colleagues, men with prostate cancer diagnosed between 2004-2012 and treated with either external beam radiation and/or prostate brachytherapy were abstracted from the National Cancer Database. Included were participants who had been clinically staged as T1c-T2aNx-0Mx-0, Gleason 6, PSA ≤ 10.0 ng/ml.
The article in the Journal of Contemporary Brachytherapy reported that 89,413 men ultimately were included in this study, of which 37,054 (41.6%) received only external beam radiation, and 52,089 (58.4%) received prostate brachytherapy.1
Results indicated that the use of brachytherapy declined over time from 62.9% in 2004 to 51.3% in 2012. This decline was noted in both academic facilities — 60.8% in 2004 to 47.0% in 2012 –as well as in non-academic facilities — 63.7% in 2004 to 53.0% in 2012.
Study authors pointed out that the decline was more significant in patients who lived closer to treatment facilities than those who lived further. At the same time, the use of intensity modulated radiation therapy increased from 18.4% in 2004 to 38.2% in 2012.
The report found that treatment at an academic center, increasing age, decreasing distance from the treatment center, and years of diagnosis from 2006-2012 were significantly associated with reduced brachytherapy usage.
“In this hospital-based registry, prostate brachytherapy usage has declined for low risk prostate cancer as intensity modulated radiation therapy usage has increased,” study authors concluded. “However, it still remains the treatment of choice for 51.3% of patients as of 2012.”
1. Safdieh J, Wong A, Weiner JP, Schwartz D, Schreiber D. Utilization of prostatebrachytherapy for low risk prostate cancer: Is the decline overstated? J Contemp Brachytherapy. 2016 Aug;8(4):289-93. doi: 10.5114/jcb.2016.61942. PubMed PMID: 27648081; PubMed Central PMCID: PMC5018529.