SBRT, proton beam therapy use increasing for prostate CA
Joshua A. Halpern, M.D., from the Weill Cornell Medical College in New York City, and colleagues compared temporal trends and outcomes for men with prostate cancer undergoing SBRT, brachytherapy, intensity-modulated radiotherapy (IMRT), and proton beam therapy (542; 9,647; 23,408; and 800 men, respectively) from 2004 to 2011.
The researchers found that the use of SBRT and proton beam therapy increased significantly (P < 0.001), while there was a decrease in brachytherapy use (P < 0.001). Compared with those treated with IMRT and proton beam therapy, a higher percentage of patients treated with SBRT and brachytherapy had low-grade cancer (Gleason score, ≤6 versus ≥7) (35.2 and 49.6 percent versus 54.0 and 64.2 percent, respectively; P < 0.001). Compared with brachytherapy and IMRT, SBRT correlated with equivalent gastrointestinal toxicity, but with more erectile dysfunction at two-year follow-up (P < 0.001). SBRT correlated with more urinary incontinence than IMRT and proton beam therapy. The median costs were $27,154 for SBRT, $17,183 for brachytherapy, $37,090 for IMRT, and $54,706 for proton beam therapy (P < 0.001).
"Despite men of lower disease stage undergoing SBRT, SBRT was found to be associated with greater toxicity but lower health care costs compared with IMRT and proton beam therapy," the authors write.
One author disclosed financial ties to the pharmaceutical industry.
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