The American Society of Clinical Oncology (ASCO) and Cancer Care Ontario today issued a joint clinical practice guideline update on brachytherapy for patients with prostate cancer. The update provides evidence-based recommendations for different patient risk groups and specifies the most effective forms of brachytherapy. The joint guideline was published in the Journal of Clinical Oncology.
"This guideline provides very clear direction about what is now the nonsurgical standard of care for the majority of patients with prostate cancer—brachytherapy either by itself or as part of a combination approach," said Andrew Loblaw, MD, FRCPC, MSc, Co-Chair of the Expert Panel that developed the guideline update, representing ASCO. "Brachytherapy is also more convenient than external-beam radiation and has a much higher chance of curing the disease. However, not every patient should have brachytherapy, and not all treatment centers are experienced in delivering high-quality brachytherapy."
The guideline recommendations pertain to men newly diagnosed with prostate cancer who require or choose active treatment and are not considering, or are not suitable, for active surveillance. Patients may be ineligible for brachytherapy if they have moderate to severe urinary symptoms, an enlarged prostate, prior prostate surgery, and contraindications to radiation treatment, or are in poor physical health.
"For the urologists, who are most often the gatekeepers in terms of first contact with men with prostate cancer, this guideline update provides new information that they can incorporate into patient counseling and treatment decision-making," said Joseph Chin, MD, FRCSC, Co-Chair of the Expert Panel that developed the guideline update, representing Cancer Care Ontario. "By optimizing treatment selection, which may or may not be brachytherapy for a particular patient, outcomes should ultimately be improved."
Key recommendations of the guideline update include:
To develop this guideline update, an Expert Panel reviewed relevant literature published between 2011 and December 2016. Five randomized controlled clinical trials provided the evidence base for this guideline update.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.