SAN FRANCISCO—Brachytherapy use for favorable-risk prostate cancer (PCa) continues to decrease even though it offers better survival than dose-escalated external beam radiation therapy (EBRT), data presented at the 2019 Genitourinary Cancers Symposium suggest.
In a study of 134,713 men who received brachytherapy or dose-escalated EBRT alone for favorable-risk PCa, Kevin A. Nguyen, MD, of the University of California, Los Angeles, and colleagues found that brachytherapy use declined significantly from 59.3% of cases in 2004 to 34.7% in 2014. Brachytherapy was consistently used more frequently at community centers (63% in 200 and 61% in 2014) than academic centers.
On multivariable analysis, black men and Asian men were 32% and 13% less likely to receive brachytherapy than whites, respectively. Men receiving care at a community center were 33% more likely receive brachytherapy that those treated at an academic center.
Men with Medicare or private insurance were more than twice as likely as those with Medicaid coverage to receive brachytherapy.
The 10-year overall survival rate was significantly higher for brachytherapy than dose-escalated EBRT (74.5% vs 68.2%).
Nguyen KA, Patel SA, Lee AK, et al. Brachytherapy use for favorable-risk prostate cancer continues to decline in both academic and community centers despite superior survival compared to dose-escalated external beam radiation therapy. Data presented at the 2019 Genitourinary Cancers Symposium held in San Francisco, February 14-16. Abstract 105.