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High Dose Rate Brachytherapy versus Low Dose Rate Brachytherapy for the Treatment of Prostate Cancer: A Review of Clinical Effectiveness and Cost-Effectiveness

Last updated: February 14, 2019
Project Number: RC1070-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the comparative clinical effectiveness of high-dose-rate versus low-dose-rate brachytherapy for the treatment of prostate cancer?
  2. What is the cost-effectiveness of high-dose-rate versus low-dose-rate brachytherapy for the treatment of prostate cancer?

Key Message

Evidence of limited to moderate quality from five non-randomized cohort studies suggested that there were no significant differences between LDR prostate brachytherapy and HDR prostate brachytherapy delivered as a monotherapy for relapse or serious adverse events. In contrast, LDR prostate brachytherapy was associated with significantly better relapse and serious adverse event profile than HDR brachytherapy when combined with External Beam Radiation Therapy (EBRT). Evidence of limited quality from one study showed that for HRQoL, LDR brachytherapy was either more favourable, less favourable, or did not differ from HDR brachytherapy monotherapy depending on the specific type of HRQoL being examined. The combined HDR and EBRT treatment option was not examined with respect to self-reported HRQoL. No evidence regarding the cost-effectiveness of high-dose-rate (HDR) brachytherapy was identified.