Authors' objectives:

The aim of this report was to assess the safety, effectiveness and cost-effectiveness of brachytherapy for treating early localised prostate cancer compared with radical prostatectomy (RP), external beam radiation therapy (EBRT), and no initial treatment or deferred treatment (active surveillance).

Authors' results and conclusions: Safety The evidence suggests brachytherapy is comparable to or better than RP and EBRT in terms of sexual functioning after treatment, and showed a relative advantage over RP in terms of rates of post-treatment urinary continence. However, brachytherapy may result in higher rates of irritative or obstructive urinary symptoms than EBRT. Disparate findings were reported regarding the relative advantage, disadvantage or comparability of brachytherapy and other treatments in terms of bowel/rectal functioning. Effectiveness The evidence available to date does not demonstrate a difference in survival or disease progression between brachytherapy, RP and EBRT in patients with early localised prostate cancer. A comparison of brachytherapy and active surveillance was not possible.

Authors' recommendations: Following a reassessment of further evidence pertaining to the safety, effectiveness and costeffectiveness of brachytherapy for the treatment of prostate cancer, interim public funding should continue for patients with prostate cancer meeting the following criteria: - at clinical stages T1 and T2 with Gleason scores of less than or equal to 6, prostate specific antigen (PSA) of less than or equal to 10 ng/ml, gland volume less than 40 cc and with life expectancy of more than 10 years; and - where the treatment is conducted at approved sites.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.msac.gov.au/reports.htm

Year Published: 2006

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Australia

Organisation Name: Medical Services Advisory Committee

Contact Address: MSAC (MDP 107), GPO Box 9848, Canberra, ACT 2601, Australia. Tel: +61 2 6289 6811; Fax: +61 2 6289 8799.

Contact Name: msac.secretariat@health.gov.au

Contact Email: msac.secretariat@health.gov.au

Copyright: Medical Services Advisory Committee (MSAC)