Study Determines that Adding External Beam Radiation and Hormonal Therapies to Brachytherapy Improves Prostate Cancer Outcomes

Using brachytherapy as the lone treatment for prostate cancer resulted in a higher mortality rate in a study by Brigham and Women’s Hospital (BWH) researchers recently published online in the Journal of Clinical Oncology.

"Despite the increasing numbers of men worldwide who choose to undergo brachytherapy alone for their high-risk, prostate cancer, the evidence supporting this treatment method alone based on survival data from randomized trials is lacking" said Anthony D'Amico, M.D., Ph.D., lead researcher and chief of genitourinary radiation oncology at BWH in a hospital press release. "In order to get the highest cure rate for men with high risk prostate cancer, it appears that five weeks of external beam radiation and at least four months of hormonal therapy should be added to brachytherapy."

The researchers assessed the difference in death risk for 1,342 men with high-risk prostate cancer who were treated with brachytherapy alone, or combined with hormone therapy and/or external beam radiation, at one of 21 community-based U.S. medical centers. Participants had a prostate-specific antigen level greater than 20 ng/mL and clinical T3 or 4, and/or a Gleason score eight to 10 disease, according to the authors of “Risk of Death From Prostate Cancer After Brachytherapy Alone or With Radiation, Androgen Suppression Therapy, or Both in Men With High-Risk Disease.”

The men treated with brachytherapy, radiation and hormonal therapy significantly reduced their risk of prostate cancer specific mortality compared with using any of the therapies alone, according to the study.

“The study disclosed that despite a higher baseline risk of death from prostate cancer, men who underwent a combination therapy of brachytherapy, hormone therapy and external beam radiation had a lower risk of death from prostate cancer…,” concluded the study authors.