A study published in September 2017, titled: ‘Quality of life after brachytherapy or bilateral nerve‐sparing robot‐assisted radical prostatectomy for prostate cancer: a prospective cohort’, compared patient quality of life after either brachytherapy or radical prostatectomy treatments.
Spanning a timescale of six years from November 2007 – January 2013, the comparative study included 181 patients who received brachytherapy and 210 patients who had undergone Robot assisted Radical Prostatectomy (RARP) – of those patients who underwent RARP, 178 had bilateral nerve‐sparing.
Quality of Life (QoL) was recorded at baseline and again, at each follow‐up using the Expanded Prostate Cancer Index Composite (EPIC) instrument. Throughout the six years, the response scores to the EPIC questionnaires were higher in the brachytherapy patients than the RARP patients: 82% versus 57% at 2 years after treatment and 55% versus 45% at 4 years after treatment. Overall, Patient satisfaction was significantly higher in the brachytherapy group at 1, 2 and 3 years after treatment. Better scores equate to better function post treatment.
Low dose-rate brachytherapy (LDR-B)
Low dose-rate brachytherapy (LDR-B) has been an established treatment for over two decades. It is a form of internal radiotherapy, which involves inserting radioactive seeds into the prostate gland. LDR-B allows surgeons to accurately target the site of a tumour and therefore avoids causing damage to healthy cells around them. The direct and non-complicated nature of the procedure equates to quicker recovery times and lower complication rates.
Robot assisted Radical Prostatectomy (RARP) on the other hand, is a major operation whereby the prostate and seminal vesicles are removed via an incision through the abdomen above the pubic bone. This process is much more invasive, carried out under general anaesthetic and results in several days spent in hospital to recover. In direct comparison, LDR-B usually takes an hour and allows most men to return to normal activities within a few days.
BXTAccelyon also offers 4D brachytherapy, a one-stage implant technique that provides optimised dosage and minimises pre-operative preparation and planning. 4D brachytherapy reduces operating theatre time and lowers the use of general anaesthetic, which in turn allows for more straightforward outpatient appointments. These advanced treatment options not only offer improved QoL outcomes for patients, they also offer treatment centres a time and cost efficient alternative to radical prostatectomy.
With LDR-B primarily seen as a secondary prostate cancer treatment option, studies like this and Ascende-RT go a long way to help change the mind-set of healthcare professionals and patients alike, increasing consideration of less invasive treatments. Enabling patient’s to make informed choices about their treatment is key, but due to lack of resources and knowledge of outcomes, patients are often lead down a less optimal and more traditional, surgical path. This study helps to shine a new light on LDR-B and provides proven data to support its use to effectively treat prostate cancer.