New Study May Help Doctors Select Prostate Cancer Treatments

Allison Gandey

April 6, 2007 — The work comparing interstitial brachytherapy and radical prostatectomy for low-risk localized prostate cancer shows that the 2 treatments share a similar cost profile, but have varying adverse effects and a different impact on quality of life. "Our study represents the first multi-institutional, prospective, and comparative study of health-related quality-of-life treatment-related symptoms, and costs in men treated by 1 of the 2 most commonly employed strategies for localized low-risk prostate cancer treatment," report lead author Catherine Buron, PhD, from the Institut Curie in Paris, France, and her team. The work appears in a recent issue of the International Journal of Radiation Oncology, Biology, Physics.
There are currently no published trials directly comparing long-term survival after treatment, leaving the question of survival benefit unanswered. However, studies have reported biochemical relapse-free survival rates that are similar up to 10 years after treatment for localized low-risk patients. Therapy with high-intensity focused ultrasound and active monitoring is being explored in other studies but, the researchers note, no long-term follow-up data are available so far.
In the current analysis, investigators studied 435 men with low-risk prostate cancer from 11 French hospitals. Patients treated with interstitial brachytherapy or radical prostatectomy were invited to complete the European Organization for Research and Treatment of Cancer core quality-of-life questionnaire and a similar prostate-cancer-specific workup. Patients completed the forms before and at the end of therapy and at 2, 6, 12, 18, and 24 months after treatment.
A major finding of the study was that mean societal costs did not differ significantly between the 2 treatments — either in the short- or long-term. "Although these costs appear to be similar, their structure differed between radical prostatectomy and interstitial brachytherapy," the researchers point out. "Mean initial treatment cost was higher in the interstitial brachytherapy than in the radical prostatectomy group, the main drivers being radioactive seed costs in the interstitial brachytherapy group and hospitalization costs in the radical prostatectomy group."