Comparative Analysis of Clinical Outcomes and Procedural Costs between the Conventional Two-stage Technique and 4D Brachytherapy for Early Prostate Cancer

To assess long-term outcomes and resource use of 4D Brachytherapy, a one-stage real-time implant for the treatment of prostate cancer that uses stranded and loose iodine-125 seeds, and to compare with the conventional two-stage (2S) technique. Prospectively collected data of men who underwent 2S and...

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Bibliographic Details
Published in:Clinical oncology (Royal College of Radiologists (Great Britain)) 2018-01, Vol.30 (1), p.57-64
Main Authors: Langley, S.E.M., Uribe, J., Uribe-Lewis, S., Money-Kyrle, J., Perna, C., Khaksar, S., Soares, R., Laing, R.
Format: Article
Language:English
Subjects:
4D brachytherapy
Brachytherapy
cost
prostate cancer
real-time planning
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Summary:To assess long-term outcomes and resource use of 4D Brachytherapy, a one-stage real-time implant for the treatment of prostate cancer that uses stranded and loose iodine-125 seeds, and to compare with the conventional two-stage (2S) technique. Prospectively collected data of men who underwent 2S and 4D low dose rate brachytherapy in a single institution were analysed. Survival estimates were analysed using the Kaplan–Meier method and Log-rank test. Treatment failure rates were further compared by Cox proportional hazards (Coxph) regression or by a surrogate prostate-specific antigen value cut-off of 0.4 ng/ml 48 months post-implant. Treatment toxicity outcomes were also evaluated. Comparative costs were based on published English National Health Service data. We compared outcomes of 690 men treated with 2S and 1031 men with 4D brachytherapy. Median follow-up times were 10.4 and 5.2 years (P 
ISSN:0936-6555
1433-2981
DOI:10.1016/j.clon.2017.09.006