Brachytherapy for prostate cancer

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #17.

The present report has been prepared as a follow up to the previous assessment because of continued interest in the technology by the health ministry and others. It considers studies that have been reported in the literature since completion of the earlier assessment (1997-1999) and focuses on the efficacy and effectiveness of the technique.

The present report confirms that brachytherapy appears a promising intervention in the short term. However, its potential for influencing overall outcomes, particularly long term morbidity and survival, are unknown. Patient selection issues discussed in the report make the prediction of its eventual effectiveness problematical. It is possible that there may be some bias in the existing reports towards selection of more promising candidates for treatment. While brachytherapy shows promise, it needs to be borne in mind that alternative or complementary treatments such as EBRT and RP are continuing to evolve so that the safety and efficacy of brachytherapy relative to these is not certain and may continue to change. These various uncertainties - which are unlikely to be resolved in the foreseeable future - pose difficulties for policy makers, health care professionals and their patients. The choice of treatment will likely continue to be made on the basis of physician and patient preference, rather than as a result of scientific proof that one treatment modality is of superior effectiveness. In terms of health care in Alberta it is suggested that the status and outcomes from the technology be kept under review. Also, any use in the province of brachytherapy for prostate cancer should be linked to long term prospective collection of patient outcomes data.

NOTE: In 2006 the Alberta Heritage Foundation for Medical Research HTA unit moved to IHE. Documents produced in and prior to 2006 have different formats; the format was determined by the agency for which the document was produced.