Authors' objectives:

The aim of this report is to evaluate the effectiveness of brachytherapy within the oncological treatments under which it is included, according to the available scientific evidence.

Authors' results and conclusions: In early stage (IIA) cervical carcinoma patients, survival after 3 years was 83%, and after 5 years 88.2% which relates to the fact that patients with later stage tumours have a worse prognosis and therefore worse survival rates. It has been shown that breast cancer patients who have undergone lumpectomy followed by brachytherapy present a higher survival rate than those treated solely with brachytherapy (61% vs. 50%, after 5 years). Those patients presenting non-operable carcinoma of the oesophagus (advanced tumoural stage), receive radiotherapy as a palliative mean. Total survival of those patients is fairly short, with median survival between 10 and 11 months. In patients suffering from colorectal carcinoma, the total local control rate and total survival rate after 5 years was 26% and 4%, respectively. Those presenting microscopic residual disease and treated post-operatively with fractionated external beam radiotherapy (EBRT), presented a significantly improved survival. The combined treatment of EBRT and PDR-brachytherapy in patients with anal carcinoma presented a local tumour control of 83%. However, a high toxicity rate associated with the treatment is observed, mainly related to necrosis. The median survival of patients suffering from pancreatic cancer was 10 months, and pain relief was obtained in 88%. After 6 months, 80% of the patients lacked tumour progression, and 50% showed a tumour regression of 30%. The use of brachytherapy in treating lung cancer patients can be performed both as a curative and palliative mean. In bladder carcinoma, after a mean follow-up of 48 months, the tumoural-disease free survival rate was 73%, and the global rate was 67%. 13% of patients showed local failure of the treatment.

Authors' recommendations: Brachytherapy is usually used in combination with fractionated external radiotherapy, surgery or chemo-therapy in the treatment of endometrial, cervical, and pancreatic cancers. Encouraging results, according to the evolution stage of the tumour, have also been obtained in the treatment of soft tissue sarcomas, vaginal and rectal cancer, early stages of lip and tongue cancer, and endobronchial carcinomas.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.isciii.es/aets/

Year Published: 2000

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Agencia de Evaluacion de Tecnologias Sanitarias

Contact Address: Instituto de Salud "Carlos III", Calle Sinesio Delgado 6, Pabellon 4, 28029 Madrid, Spain. Tel: +34 9 1 822 2005; Fax: +34 9 1 387 7841;

Contact Name: Luis M. Sánchez Gómez

Contact Email: luism.sanchez@isciii.es

Copyright: Agencia de Evaluacion de Tecnologias Sanitarias