Radical retropubic prostatectomy versus brachytherapy for low-risk prostatic cancer: a prospective study

Giberti, Claudio; Chiono, Luciano; Gallo, Fabrizio; Schenone, Maurizio; Gastaldi, Emilio

doi:10.1007/s00345-009-0418-9

Cited by 106 publications

(105 citation statements)

References 22 publications

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“…One small Italian trial randomized 200 patients to receive RP or PB. 4 With a median follow up of 5 years, PRFS was the same in both groups (91%). At 6 months and 1 year follow-up, brachytherapy patients had more irritative urinary symptoms but better sexual function.…”

Section: Time Since Implant (Mo)mentioning

confidence: 88%

“…4 Level II evidence (non-randomized comparison and cohort studies) is available for all treatments. A large, recently published systematic review compares all treatment options in prostate cancer and provides some insights into the comparative effectiveness of prostate cancer treatments using current modern literature results (848 articles and more than 50 000 patients).…”

Section: Quality Of Evidencementioning

confidence: 99%

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Chapter 4

2008

Treatment Methods for Early and Advanced Prostate Cancer

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Objective To describe treatment options for clinically localized prostate cancer: radical prostatectomy, prostate brachytherapy, external beam radiation, and active surveillance. Quality of evidence Prostate-specific antigen (PSA) outcomes presented are from non-randomized, cohort, and other comparisons trials (level II evidence). We describe PSA outcomes from Canadian centres when they are available. One small randomized controlled trial (level I evidence) in localized prostate cancer is available to compare radical prostatectomy with brachytherapy. Main message Treatment choice in prostate cancer is based on initial PSA level, clinical stage of disease, and Gleason score, together with baseline urinary function, comorbidities, and patient age. In this article, we describe patients' eligibility for and the common side effects of all treatment options. Prostate brachytherapy and active surveillance have evolved as new standard treatments of localized prostate cancer. We give a brief overview of the brachytherapy procedure, side effects, and PSA outcomes across Canada, as well as active surveillance guidelines. Conclusion Prostate cancer treatment requires a multidisciplinary approach, with input from both urology and radiation oncology. Input from family physicians is often as important in helping guide patients through the treatment decision process. Options de traitement du cancer localisé de la prostate RésuméObjectif Décrire les options de traitement du cancer de la prostate cliniquement localisé: la prostatectomie radicale, la curiethérapie de la prostate, la radiothérapie externe et la surveillance active. Qualité des données

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Section: Time Since Implant (Mo)mentioning

confidence: 88%

Section: Quality Of Evidencementioning

confidence: 99%

Chapter 4

2008

Treatment Methods for Early and Advanced Prostate Cancer

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“…I den ble 200 pasienter ble randomisert til enten til lavdoseterapi eller radikal kirurgi (7). Primaert effektmål var fem år PSA-fri overlevelse (91 % for kirurgi versus 91,7 % for lavdoserate brakyterapi).…”

Section: Effektmålunclassified

Lavdoserate brakyterapi ved lavgradig prostatakreft

Raabe¹,

Normann²,

Lilleby³

2015

Tidsskriftet

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RESULTATER Basert på langtidsobservasjoner av effekt, bivirkninger og kostnader presentert i 43 selekterte studier, deriblant én randomisert, kontrollert studie, er det fremdeles usikkerhet omkring hvilken metode som er best når man sammenlikner lavdose brakyterapi, ekstern strålebehandling og radikal prostatektomi. Årsaken er metodiske forskjeller i pasientutvalg og effektestimater, som PSA-fritt intervall og prostataspesifikk overlevelse. Kunnskapsgrunnlaget kan tyde på at lavdoserate brakyterapi gir hyppigere legerapporterte urogenitale bivirkninger grad 2 og grad 3 sammenliknet med prostatektomi, men bedre pasientrapporterte seksuelle funksjoner og faerre pasienter med urininkontinens enn etter kirurgi. Lavdoserate brakyterapi synes å vaere samfunnsmessig kostnadsbesparende.FORTOLKNING Kunnskapsgrunnlaget med henblikk på behandlingseffekt og toksisitet hos menn med lavrisiko prostatakreft som behandles med lavdoserate brakyterapi anses som solid dokumentert. Det mangler imidlertid gode prospektive randomiserte multisenterstudier med totaloverlevelse som endepunkt.

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“…А через 5 лет у пациентов после простатэктомии значительно чаще наблюдались стриктуры уретры (6,5% против 2%) и недержание мочи (18% против 0%). Доказана большая безопасность ВМБТ в аспекте краткосрочных ослож-нений [17].…”

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