Higher quality of life after brachytherapy

Current results of the two-year SPIRIT-Study prove clear advantages of the brachytherapy

Higher quality of life, rarely occurring incontinence and improved erectile function. The latest results from the SPIRIT study demonstrated clear advantages of brachytherapy over radical prostatectomy in patients with localized prostate cancer. Even in terms of patient satisfaction brachytherapy is far superior to an operation.

In patients with prostate carcinoma, brachytherapy, external irradiation, and surgery lead equal recovery rates, provided the tumor is detected at an early stage. This has already been clearly demonstrated in numerous studies1. In contrast, data on the quality of life in successfully treated patients are very rare. "We have to consider when choosing the appropriate therapy that it is not only about recovery rates, but also about the impact of the treatment on the quality of life" says Dr. Pedram Derakhshani, urologist at the West German Prostate Center.

Recently, in a large-scale study2, brachytherapy and surgical removal of the prostate were compared in terms of their health-related quality of life using standardized questionnaires. The survey asked for the functions of the urinary bladder (voiding) and continence, erectile function, abnormal bowel function, effects of hormonal treatment, and the patient’s satisfaction. No differences between the two forms of therapy, however, resulted in intestine-and hormone-specific questions.
The results show that factors important for the quality of life after the treatment are clearly more positive in brachytherapy than in radical prostatectomy. It was found that brachytherapy compared to radical prostatectomy is less impairing on sexuality and rarely leads to urinary incontinence.

"The results are consistent with the guidelines of the German Society of Urology (DGU)," explains Dr. Derakhshani. It states that prostate cancer patients who receive brachytherapy for the treatment suffer significantly less often restrictions to their potency than patients after surgery. Also urinary incontinence, which after the radical removal of the prostate is close to 50 percent, is with 0.3 to 3 percent after seed implantation negligible and occurs in fact only after preceding prostate enucleation (TURP).

Literature:
1 Kupelian PA et. al.: Radical prostatectomy, external beam radiotherapy or =72 Gy, permanent seed implantation, or combined seeds/external beam radiotherapy for stage T1-T2 prostate cancer. Int J Radiat Oncol Biol Phys. 2004 Jan 1;58(1):25-33.

2Crook JM et al. Comparison of health-related quality of life 5 years after SPIRIT: Surgical prostatectomy versus interstitial radiation intervention trail. J ClinOncol.2011 Feb1; 29(4):362-8. Epub 2010 Dec 13.