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PSA: Declining utilization of prostate brachytherapy.

Lauren Andring1, Alison Yoder1, Todd Pezzi1

  • 1Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX.

Brachytherapy
|August 23, 2021
PubMed
Summary
This summary is machine-generated.

Brachytherapy use for prostate cancer is declining, with fewer patients receiving this radiation therapy. Factors like age, insurance, and treatment center impact its utilization, signaling a need for further investigation.

Keywords:
BrachytherapyHealth-care expenditureProstate cancerRadiation

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Urologic Oncology

Background:

  • Prostate cancer is a leading cause of cancer death in men.
  • Radiation therapy, including brachytherapy and external beam radiation therapy (EBRT), is a primary treatment modality.
  • Brachytherapy offers a targeted approach to prostate cancer treatment.

Purpose of the Study:

  • To analyze trends in brachytherapy utilization for prostate cancer from 2010-2015.
  • To identify patient characteristics and demographic factors associated with brachytherapy use.
  • To evaluate predictors of brachytherapy utilization in localized prostate cancer.

Main Methods:

  • Retrospective analysis of National Cancer Database (NCDB) data from 2010-2015.
  • Inclusion of patients with localized prostate adenocarcinoma treated with definitive radiation therapy.
  • Evaluation of utilization rates for external beam radiation (EBRT), brachytherapy (BT), and combination therapy (EBRT + BT).
  • Univariable and multivariable analyses to identify predictive factors for brachytherapy use.

Main Results:

  • EBRT use increased from 67% to 78%, while overall brachytherapy use decreased from 33% to 22% between 2010 and 2015.
  • Brachytherapy monotherapy decreased from 25% to 16%, and combination therapy (EBRT + BT) decreased from 8% to 6%.
  • Factors associated with lower brachytherapy use included older age, government/no insurance, intermediate/high-risk disease, and academic center treatment.
  • Younger patients, private insurance, lower risk disease, and non-academic center treatment were linked to higher brachytherapy utilization.

Conclusions:

  • Brachytherapy utilization for prostate cancer shows a consistent decline over time.
  • Treatment at academic centers is associated with a reduced likelihood of brachytherapy use.
  • The decreasing use of brachytherapy has implications for resident training, patient care, and healthcare costs.