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Stereotactic Ablative Radiotherapy Versus Low Dose Rate Brachytherapy or External Beam Radiotherapy: Propensity Score
A Loblaw1, T Pickles2, J Crook3
1Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Health Policy, Measurement and Evaluation, University of Toronto, Toronto, Ontario, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Clinical Oncology (Royal College of Radiologists (Great Britain))
|October 27, 2016
Summary
Stereotactic ablative radiotherapy (SABR) showed similar biochemical failure-free survival (BFFS) for prostate cancer compared to low dose rate (LDR) brachytherapy, but better BFFS than external beam radiotherapy (EBRT).
Area of Science:
- Oncology
- Radiation Oncology
- Urology
Background:
- Prostate cancer treatment involves various radiotherapy techniques.
- Comparing stereotactic ablative radiotherapy (SABR), low dose rate (LDR) brachytherapy, and external beam radiotherapy (EBRT) is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare biochemical failure-free survival (BFFS) and overall survival for prostate cancer treated with SABR, LDR, or EBRT.
- Utilize a large Canadian multi-institutional database for robust comparative analysis.
Main Methods:
- Retrospective analysis of low-risk localized prostate cancer patients treated with SABR, LDR, or EBRT without androgen deprivation therapy.
- Propensity score matching to create comparable cohorts for LDR and EBRT control groups.
- Kaplan-Meier survival analysis and Cox proportional hazards regression to assess BFFS and overall survival.
Main Results:
- No significant difference in BFFS between SABR and LDR, though LDR showed a lower PSA nadir.
- SABR demonstrated a significant improvement in BFFS compared to EBRT after propensity score matching.
- Median follow-up exceeded 5.0 years in a cohort of 602 patients.
Conclusions:
- SABR offers similar BFFS to LDR and superior BFFS compared to EBRT for low-risk prostate cancer.
- Further research is needed to evaluate efficacy, quality of life, and economic outcomes across a broader range of prostate cancer risk strata.
