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Brachytherapy Treatment Advantages

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Compared to Robotic Prostatectomy Brachytherapy
Gastrointestinal Side Effects Very few GI or rectal side effects have been reported. Acceptable side effects comparable to other treatments (1)
Incontinence Higher degree of poor urinary function(1) Less impact on urinary function than surgery (1)
Impotence Higher degree of sexual dysfunction (1) Higher degree of sexual function reported at three year follow up(1)
Length of Procedure 3-4 hours 45 minutes to 1 hour for complete implant
Hospitalization Up to 4 days Rarely required
Length of time therapy has been in use Early reports of robotic surgery began in 2003 (2) First ultra sound guided implant performed in 1985
Published rates of effectiveness* 83% control rates achieved at high volume centers (6) Up to 99% of patients in long term studies (7)
Compared to IMRT (External Beam Radiation) Brachytherapy
Gastrointestinal Side Effects Late rectal morbidity likely (4) Occurs in approximately 9% of patients treated (5)
Incontinence Urinary bother occurs in 12-40% of patients treated (4) Urinary bother occurs in approximately 15% of patients
Impotence Approximately 78% of patients maintain sexual function (8) High degree of sexual function is maintained (1)
Length of Procedure Five days per week for up to nine weeks. 45 minutes to 1 hour for complete implant
Hospitalization Hospitalization is rarely required Rarely required
Length of time therapy has been in use IMRT adaptation acceleration began in 2003 First ultra sound guided implant performed in 1985
Published rates of effectiveness* 89% of patients in long term study (4) Up to 99% of patients in long term studies (7)
Compared to Proton Beam Therapy Brachytherapy
Gastrointestinal Side Effects Greater degree of late rectal side effects has been reported (8) Occurs in approximately 9% of patients treated (5)
Incontinence Urinary bother occurs in approximately 22% of patients (8) Urinary bother occurs in approximately 15% of patients
Impotence Similar percentages to IMRT (8) High degree of sexual function is maintained (1)
Length of Procedure Five days per week for up to nine weeks 45 minutes to 1 hour for complete implant
Hospitalization Rarely required Rarely required
Length of time therapy has been in use Ten year data has been reported First ultra sound guided implant performed in 1985
Published rates of effectiveness* 73% of patients in long term study (8) Up to 99% of patients in long term studies (7)
Compared to Cyber Knife Brachytherapy
Gastrointestinal Side Effects Occurs in approximately 12% of patients Occurs in approximately 9% of patients treated (5)
Incontinence 31% of patients experience urinary bother (9) Urinary bother occurs in approximately 15% of patients
Impotence Not reported in papers reviewed High degree of sexual function is maintained (1)
Length of Procedure Up to one hour per treatment for five treatments typically over five to ten days 45 minutes to 1 hour for complete implant
Hospitalization Rarely required Rarely required
Length of time therapy has been in use Typical reports have been over five years or less. First ultra sound guided implant performed in 1985
Published rates of effectiveness* 94% of patients (9) Up to 99% of patients in long term studies (7)
*Effectiveness is defined as freedom from bio-chemical progression.

1. “Quality of Life After Open or Robotic Prostatectomy, Cryoblation or Brachytherapy for Localized Prostate Cancer”, John B. Malcolm et al, Journal of Urology, Vol 183, 1822-1829, May 2010

2. “Utilization and Outcomes of Minimally Invasive Radical Prostatectomy”, Jim C. Hu et al, Journal of Clinical Oncology, Vol 24, Number 14, May 10 2008

3. “Proton Therapy for Prostate Cancer: the Initial Loma Linda University Experience”, Jerry D. Slater et al, International Journal of Radiation Oncology, Biology and Physics, Vol. 59, Number 2, Pgs 348-352, 2004

4. “Comparison of Tumor Control and Toxicity Outcomes of High Dose Intensity Modulated Radiotherapy and Brachytherapy for Patients with Favorable Risk Prostate Cancer” Michael J. Zelefsky et al, Urology, Vol 77, Issue 4, Pgs 986-999, April 2011

5. “I-125 vs Pd-103 for Low Risk Prostate Cancer: Long Term Morbidity Outcomes From a Prospective Randomized Multicenter Controlled Trial”, Andrew Herstein et al, The Cancer Journal, Vol 11, Number 5, Pgs 385-389, September/October 2005

6. “Robotic Prostatectomy FAQ’s” City of Hope Web Site, 2012

7. “Brachytherapy in Men Aged ≤54 Years with Clinically Localized Prostate Cancer”, Gregory S. Merrick et al, British Journal of Urology, Vol 98, Pgs 324-328, 2006

8. “Intensity-Modulated Radiation Therapy, Proton Therapy, or Conformal Radiation Therapy and Morbidity and Disease Control in Localized Prostate Cancer”, Nathan C. Sheets et al, JAMA, Vol 307, Number 15, April 18, 2012

9. “Long Term Outcomes from a Prospective Trial of Stereotactic Body Radiotherapy for Low Risk Prostate Cancer”, International Journal of Radiation Oncology, Biology and Physics, Vol 82, Number 2, Pgs 877-882, 2012