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Brachytherapy for prostate cancer: a systematic review of clinical and cost effectiveness
Inger Norderhaug1, Olav Dahl, Per A Høisaeter
1The Norwegian Centre for Health Technology Assessment, SINTEF Unimed, Postbox 124, Blindern, 0314 Oslo, Norway. inger.n.norderhaug@unimed.sintef.no
Objectives:
Brachytherapy is emerging as a new treatment option for prostate cancer, and is increasingly being used in Europe and North America.
Methods:
A systematic review of studies that compared clinical or cost effectiveness of prostate brachytherapy with radical prostatectomy or external beam radiation for patients with localised prostate cancer.
Results:
No randomised controlled trials were identified, but five observational studies with comparable patient groups were included in the review. There were no valid data on overall or disease-free survival. There was no difference in disease-free survival based on PSA as a surrogate measure, or in rates of complications. No cost effectiveness studies were found. Based on Norwegian data, the one-year cost of the three treatment options seem fairly similar, while long term cost data are lacking due to lack of data on long term clinical outcome.
Conclusion:
The evidence on the clinical effectiveness of therapies for localised prostate cancer is scarce, but the outcome appears to be comparable for radical prostatectomy, external beam radiotherapy and brachytherapy.