Brachytherapy versus prostatectomy in localized prostate cancer: results of a French multicenter prospective medico-economic study Brachytherapy versus prostatectomy in localized prostate cancer: results of a French multicenter prospective medico-economic study Brachytherapy versus prostatectomy in localized prostate cancer: results of a French multicenter prospective medico-economic study Buron C, Le Vu B, Cosset JM, Pommier P, Peiffert D, Delannes M, Flam T, Guerif S, Salem N, Chauveinc L (...) prostate cancer treatment. The authors concluded societal costs were similar, quality of life was generally worse with IB, and symptom profiles differed by intervention. The study was generally well reported and conducted. Missing data may affect the results. Survival data and longer follow-up would aid assessment of the comparative cost-effectiveness of the interventions. Type of economic evaluation Cost-effectiveness analysis Study objective The study evaluated health related quality of life (HRQoL

Survival associated with treatment vs observation of localized prostate cancer in elderly men. Prostate-specific antigen screening has led to an increase in the diagnosis and treatment of localized prostate cancer. However, the role of active treatment of low- and intermediate-risk disease in elderly men is controversial.To estimate the association between treatment (with radiation therapy or radical prostatectomy) compared with observation and overall survival in men with low- and intermediate (...) -risk prostate cancer.Observational US cohort from Surveillance, Epidemiology, and End Results Medicare data.At total of 44,630 men aged 65 to 80 years who were diagnosed between 1991 and 1999 with organ-confined, well- or moderately differentiated prostate cancer and who had survived more than a year past diagnosis. Patients were followed up until death or study end (December 31, 2002). Patients were classified as having received treatment (n=32,022) if they had claims for radical prostatectomy

☆ Nephrology ★★★★★★☆ METHODS Design: randomised controlled trial (Scandinavian Prostate Cancer Group Study Number 4). Allocation: {concealed} . Blinding: blinded {outcome assessors, data safety and monitoring committee, and data analysts} . Follow-up period: mean 8.5–8.8 years (median 8.2 y). Setting: 14 centres in Sweden, Finland, and Iceland. Patients: 695 men <75 years of age (mean age 65 y) with newly diagnosed, untreated, localised prostate cancer; tumour stage T0d (later changed to T1b), T1, or T2 (...) conclusions in favour of RP. It would be difficult now to defend such a policy: WW has been replaced by active surveillance. This is not mere semantics; patients are followed closely and at any hint of disease progression, appropriate systemic therapy is started. The study did not include radiotherapy, either external beam (EBRT) or brachytherapy. Both forms are effective in early prostate cancer, but no modern randomised trials have compared radiotherapy with either WW or RP. The ProtecT study in the UK

Chemotherapy for hormone-refractory prostate cancer. Prostate cancer mainly affects elderly men, and its incidence has steadily increased over the last decade. The management of this disease is replete with controversy. In men with advanced, metastatic prostate cancer, hormone therapy is almost universally accepted as the initial treatment of choice and produces good responses in most patients. However, many patients will relapse and become resistant to further hormone manipulation; the outlook (...) for these patients is poor. Many have disease extending to the skeleton, which is associated with severe pain. Therapies for these men include chemotherapy, bisphosphonates, palliative radiotherapy, and radioisotopes. Systemic chemotherapy has been evaluated in men with hormone-refractory prostate cancer (HRPC) for many years, with disappointing results. However, more recent studies with newer agents have shown encouraging results. There is therefore a need to explore the value of chemotherapy

in Connecticut, USA. Patients: 767 men 55–74 years of age (mean age 69 y) diagnosed with clinically localised prostate cancer between 1 January 1971 and 31 December 1984 who were treated with observation or immediate or delayed androgen withdrawal therapy. Exclusion criteria were surgery, radiation therapy, brachytherapy, known metastatic disease, concomitant cancer, or survival <6 months. Prognostic factors: age at diagnosis, treatment method, comorbid conditions, and tumour grade according to Gleason score (...) (range 2–10; 10 = most undifferentiated). Outcomes: death from prostate cancer or other competing causes. MAIN RESULTS Prostate cancer mortality rates were 33 deaths per 1000 person years (95% CI 28 to 38) in the first 15 years of follow up and 18 deaths per 1000 persons years (CI 10 to 29) after 15 years. After adjusting for Gleason score, the rates before and after 15 years did not differ (rate ratio 1.1, CI 0.6 to 1.9). Men with low grade tumours had low risk of dying from prostate cancer over

Viewpoint: limiting prostate cancer screening. Prostate cancer screening is controversial, and major professional associations offer differing screening guidelines. The author addresses 3 key issues about prostate cancer screening: 1) the prostate-specific antigen (PSA) criteria to recommend a prostate biopsy, 2) the appropriate age to start screening, and 3) the appropriate age to stop screening. The author argues, on the basis of evidence published since 2000, that data supporting

Viewpoint: expanding prostate cancer screening. Prostate cancer screening is controversial, and major professional associations offer differing screening guidelines. The authors address 3 key issues about prostate cancer screening: 1) the prostate-specific antigen (PSA) criteria to recommend a prostate biopsy, 2) the appropriate age to start screening, and 3) the appropriate age to stop screening. The authors argue, on the basis of evidence published since 2000, that data supporting

in the development of this guideline which has led to this more specific recommendation. More information is available from . The IP guidance on high dose rate brachytherapy in combination with external-beam radiotherapy for localised prostate cancer remains current, and should be read in conjunction with the clinical guideline. Description Prostate cancer is one of the most common cancers in men. It tends to affect older men, with the risk rising with age. It is not a single disease entity but may be indicated (...) from an incidental biopsy finding to presentation with metastatic prostate cancer, which may or may not cause any symptoms or shorten life. Symptoms when they occur include urinary outflow obstruction and features of metastases, such as bone pain. Prognosis with prostate cancer is variable and depends on the grade of the tumour and stage of the diagnosed cancer. Treatment options depend on the stage of the cancer. Brachytherapy is a form of radiotherapy in which delivery of radiation is targeted

Docetaxel for the treatment of hormone-refractory metastatic prostate cancer (TA101) Overview | Docetaxel for the treatment of hormone-refractory metastatic prostate cancer | Guidance | NICE Docetaxel for the treatment of hormone-refractory metastatic prostate cancer Technology appraisal guidance [TA101] Published date: 28 June 2006 Share Guidance on docetaxel for treating hormone-refractory metastatic prostate cancer in adults. Guidance development process Is this guidance up to date? . We

Adjuvant radiotherapy for pathologically advanced prostate cancer: a randomized clinical trial. Despite a stage-shift to earlier cancer stages and lower tumor volumes for prostate cancer, pathologically advanced disease is detected at radical prostatectomy in 38% to 52% of patients. However, the optimal management of these patients after radical prostatectomy is unknown.To determine whether adjuvant radiotherapy improves metastasis-free survival in patients with stage pT3 N0 M0 prostate (...) undergone radical prostatectomy for pathologically advanced prostate cancer, adjuvant radiotherapy resulted in significantly reduced risk of PSA relapse and disease recurrence, although the improvements in metastasis-free survival and overall survival were not statistically significant. Trial Registration clinicaltrials.gov Identifier: NCT00394511.

of the analysis cannot be extrapolated to the treatment of men with good-risk prostate cancer since epidemiological data referred to patients with intermediate-risk disease. Implications of the study The study results support the use of IMRT for the treatment of intermediate-risk prostate cancer, although this conclusion was highly dependent on the time horizon of the analysis and the improvements in QoL associated with treatment. The authors noted that further studies should investigate the potential (...) of increased second malignancies with IMRT. Source of funding None stated. Bibliographic details Konski A, Watkins-Bruner D, Feigenberg S, Hanlon A, Kulkarni S, Beck J R, Horwitz E M, Pollack A. Using decision analysis to determine the cost-effectiveness of intensity-modulated radiation therapy in the treatment of intermediate risk prostate cancer. International Journal of Radiation Oncology, Biology, Physics 2006; 66(2): 408-415 Other publications of related interest Because readers are likely

prostate cancer. Health Econ 2002;11:233-48. Sanguineti G, Agostinelli S, Foppiano F, et al. Adjuvant androgen deprivation impacts late rectal toxicity after conformal radiotherapy of prostate carcinoma. Br J Cancer 2002;86:1843-7. Indexing Status Subject indexing assigned by NLM MeSH Adenocarcinoma /drug therapy /economics /radiotherapy; Androgen Antagonists /economics /therapeutic use; Antineoplastic Agents, Hormonal /economics /therapeutic use; Combined Modality Therapy; Cost-Benefit Analysis (...) . Modelling A Markov model was set up to assess the costs and benefits of LTAD versus STAD in a cohort of patients with locally advanced prostate carcinoma. The time horizon of the model was 10 years and the cycle length was 1 year. The health states considered in the model were no disease progression, hormone-responsive disease progression, hormone-unresponsive disease progression and death. The allowable state transitions were from no disease progression, to hormone-responsive disease progression

cryoprobes to freeze and, thereby, destroy cancerous prostate tissue. Cryoablation is being investigated as a primary treatment alternative to surgery or radiotherapy for clinically localized prostatic carcinoma and as a second line or salvage treatment for patients with residual or recurrent cancer following radical prostatectomy or irradiation. Final publication URL The report may be purchased from: Indexing Status Subject indexing assigned by CRD MeSH Cryosurgery /utilization; Prostatic Neoplasms (...) Cryoablation for prostate cancer Cryoablation for prostate cancer Cryoablation for prostate cancer Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Cryoablation for prostate cancer. Lansdale: HAYES, Inc.. Directory Publication. 2006 Authors' objectives Cryoablation for prostate cancer is a minimally invasive surgical technique that uses percutaneously inserted

.. Directory Publication. 2006 Authors' objectives Three-dimensional conformal radiation therapy (3D CRT) uses advanced computer technology to tailor the radiotherapy beam to the exact size and shape of a tumor, while minimizing incidental irradiation of surrounding normal tissues. Using 3D CRT in patients with prostate cancer allows delivery of higher doses of radiation to the prostate than would be possible with conventional external beam radiation therapy, with the objective of improving local control (...) and, ultimately, survival. Intensity-modulated radiation therapy (IMRT), the latest conformal radiation therapy development, combines two advanced concepts to deliver 3D CRT to tumors at the higher dosages with enhanced precision: (1) inverse treatment planning with optimization by computer; and (2) computer-controlled intensity modulation of the radiation beam during treatment. Final publication URL The report may be purchased from: Indexing Status Subject indexing assigned by CRD MeSH Prostatic Neoplasms

Prostate cancer gene 3 (Progensa PCA3) assay in the diagnosis of prostate cancer: horizon scanning technology briefing Prostate cancer gene 3 (Progensa PCA3) assay in the diagnosis of prostate cancer: horizon scanning technology briefing Prostate cancer gene 3 (Progensa PCA3) assay in the diagnosis of prostate cancer: horizon scanning technology briefing NHSC Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation (...) of the quality of this assessment has been made for the HTA database. Citation NHSC. Prostate cancer gene 3 (Progensa PCA3) assay in the diagnosis of prostate cancer: horizon scanning technology briefing. Birmingham: National Horizon Scanning Centre (NHSC). 2006 Authors' objectives This study examines the use of prostate cancer gene 3 (Progensa PCA3) assay in the diagnosis of prostate cancer. Timeliness warning Available on request from NHSC. Final publication URL Indexing Status Subject indexing assigned

resonance spectroscopy for prostate cancer: horizon scanning technology briefing. Birmingham: National Horizon Scanning Centre (NHSC). 2006 Authors' objectives This study examines the use of magnetic resonance spectroscopy for prostate cancer. Timeliness warning Available on request from NHSC. Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Magnetic Resonance Spectroscopy /diagnostic use; Prostatic Neoplasms /diagnosis Language Published English Country of organisation (...) Magnetic resonance spectroscopy for prostate cancer: horizon scanning technology briefing Magnetic resonance spectroscopy for prostate cancer: horizon scanning technology briefing Magnetic resonance spectroscopy for prostate cancer: horizon scanning technology briefing NHSC Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation NHSC. Magnetic

Simultaneous irradiation (ProstRcision) for localized prostate cancer Simultaneous irradiation (ProstRcision) for localized prostate cancer Simultaneous irradiation (ProstRcision) for localized prostate cancer HAYES, Inc. Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc.. Simultaneous irradiation (ProstRcision) for localized prostate cancer. Lansdale (...) : HAYES, Inc.. Directory Publication. 2006 Authors' objectives Simultaneous irradiation, or ProstRcision, is a prostate cancer treatment provided exclusively at the Radiotherapy Clinics of Georgia. It involves high-dose brachytherapy followed by external beam radiation therapy while the brachytherapy seeds are still active. An integral part of the procedure is the targeting of a post-treatment serum prostate-specific antigen (PSA) nadir of 0.2 ng/mL and an assessment of treatment failure if the PSA

Proton beam therapy for prostate cancer Proton beam therapy for prostate cancer Proton beam therapy for prostate cancer HAYES, Inc. Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc.. Proton beam therapy for prostate cancer. Lansdale: HAYES, Inc.. Directory Publication. 2006 Authors' objectives Proton beam therapy (PBT) is a type of external radiation (...) treatment in which positively charged subatomic particles (protons) are precisely targeted to a specific tissue mass by using a sophisticated stereotaxic planning and delivery system. In comparison with conventional photon irradiation, proton beam radiation may deliver a higher dose to the target tissue, while minimizing exposure to surrounding healthy tissue. Final publication URL The report may be purchased from: Indexing Status Subject indexing assigned by CRD MeSH Neutrons; Prostatic Neoplasms

Neutron beam therapy for prostate cancer Neutron beam therapy for prostate cancer Neutron beam therapy for prostate cancer HAYES, Inc. Citation HAYES, Inc.. Neutron beam therapy for prostate cancer. Lansdale: HAYES, Inc.. Directory Publication. 2006 Authors' objectives Neutron beam therapy (NBT) is a form of external beam radiotherapy in which accelerated neutral subatomic particles (neutrons) are targeted to a tumor mass, with the goal of eradicating malignant cells. Unlike standard photon (x (...) -ray) radiotherapy (XRT), which is characterized by low linear energy transfer (LET), NBT involves high-LET. Compared with XRT, the high-LET of NBT is associated with greater cell killing per unit dose and, theoretically, is superior in overcoming radioresistance in slowly proliferating tumors such as prostate adenocarcinoma. Final publication URL The report may be purchased from: Indexing Status Subject indexing assigned by CRD MeSH Neutrons; Prostatic Neoplasms /radiotherapy; Radiotherapy

High dose rate brachytherapy in combination with external-beam radiotherapy for localised prostate cancer High dose rate brachytherapy in combination with external-beam radiotherapy for localised prostate cancer High dose rate brachytherapy in combination with external-beam radiotherapy for localised prostate cancer National Institute for Health and Clinical Excellence Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality (...) of this assessment has been made for the HTA database. Citation National Institute for Health and Clinical Excellence. High dose rate brachytherapy in combination with external-beam radiotherapy for localised prostate cancer. London: National Institute for Health and Clinical Excellence (NICE). Interventional Procedure Guidance 174. 2006 Authors' objectives This study aims to assess the current evidence on high dose rate brachytherapy in combination with external-beam radiotherapy for localised prostate cancer