Brachytherapy in early localized prostate cancer Brachytherapy in early localized prostate cancer Brachytherapy in early localized prostate cancer Comite d' Evaluation et de Diffusion des Innovations Technologiques 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 Comite d' Evaluation et de Diffusion des Innovations Technologiques (...) . Brachytherapy in early localized prostate cancer. Paris: Comite d´Evaluation et de Diffusion des Innovations Technologiques (CEDIT). 01.06. 2001 Authors' objectives This report aims to assess the wider application of brachytherapy in the treatment of forms of early localized prostate cancer. Authors' conclusions The CEDIT is of the opinion that there are too many reservations regarding brachytherapy as a treatment for early localized prostate cancer in terms of exact indications, methodology, effectiveness

, refer to the need for randomised controlled trials (including the analysis of serial screening over a longer term) to appropriately quantify the costs and benefits of prostate cancer screening. Source of funding None stated. Bibliographic details Benoit R M, Gronberg H, Naslund M J. A quantitative analysis of the costs and benefits of prostate cancer screening. Prostate Cancer and Prostatic Diseases 2001; 4(3): 138-145 PubMedID DOI Other publications of related interest Richie JP, Catalona WJ (...) A quantitative analysis of the costs and benefits of prostate cancer screening A quantitative analysis of the costs and benefits of prostate cancer screening A quantitative analysis of the costs and benefits of prostate cancer screening Benoit R M, Gronberg H, Naslund M J Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed

Maximal androgen blockade for advanced prostate cancer. This systematic review assessed the effect of maximal androgen blockade (MAB) on survival when compared to castration (medical or surgical) alone for patients with advanced prostate cancer.Randomized controlled trials were searched in general and specialized databases (MEDLINE, EMBASE, Cancerlit, Cochrane Library, VA Cochrane Prostate Disease register) and by reviewing bibliographies.All published randomized trials were eligible (...) for inclusion provided they (1) randomized men with advanced prostate cancer to receive a non-steroidal anti-androgen (NSAA) medication in addition to castration (medical or surgical) or to castration alone, and (2) reported overall survival, progression-free survival, cancer-specific survival, and/or adverse events. Eligibility was assessed by two independent reviewers.Information on patients, interventions, and outcomes were extracted by two independent reviewers using a standardized form. The main

Using the free-to-total prostate-specific antigen ratio to detect prostate cancer in men with nonspecific elevations of prostate-specific antigen levels Using the free-to-total prostate-specific antigen ratio to detect prostate cancer in men with nonspecific elevations of prostate-specific antigen levels Using the free-to-total prostate-specific antigen ratio to detect prostate cancer in men with nonspecific elevations of prostate-specific antigen levels Hoffman R M, Clanon D L, Littenberg B (...) , Frank J J, Peirce J C Authors' objectives To determine whether the free-to-total prostate-specific antigen (PSA) ratio improved the diagnostic accuracy of non-specific PSA results. Searching MEDLINE was searched from January 1986 to July 1997 for publications in the English language. The search used a combination of the MeSH terms 'prostate-specific antigen' and 'prostatic neoplasm' and then linked them with 'alpha-1-antichymotrypsin' or with 'free' or 'gamma-semiprotein'. The bibliographies

Contrasting costs of a prostate cancer educational program by income Contrasting costs of a prostate cancer educational program by income Contrasting costs of a prostate cancer educational program by income Weinrich S P, Weinrich M, Ellison G, Hudson J, Reeder G, Weissbecker I Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed (...) by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of two alternative educational interventions, oriented to inform the risks and benefits of prostate cancer screening. There were followed by screening, using a digital rectal examination (DRE) and/or drawing of blood for a prostate-specific antigen (PSA) test, and a biopsy for those men with abnormal results. The core of the educational interventions included a slide-tape presentation

cyproterone acetate. MAB was given for 18, 24 or 36 months, or until disease progression. The AS comparators were: orchiectomy; orchiectomy plus cyproterone for 14 days; leuprolide; leuprolide plus flutamide for 15 days; goserelin; buserelin; and buserelin plus cyproterone for 14 days. Participants included in the review Studies of men with advanced prostate cancer were eligible for inclusion. Men with metastatic (88%) and locally advanced (12%) cancer were included. The men's ages ranged from younger (...) was used to combine the studies by pooling the log rank statistic for mortality, and its variance, which were calculated for each trial. A meta-analysis stratified by years of follow-up, age, and stage of disease was also conducted. Survival curves were plotted to determine 5-year survival. All of the analyses were conducted by intention-to-treat and a 2-sided P-test was used to test for statistical significance. Deaths reported to arise from other causes (i.e. not prostate cancer) were analysed

of prostate cancer patients by on-demand contacts with a specialist nurse: a randomized study. Scandinavian Journal of Urology and Nephrology 2000; 34(1): 55-61 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Aged; Aged, 80 and over; Cost-Benefit Analysis; Disease Progression; Follow-Up Studies; Humans; Male; Middle Aged; Neoplasm Staging; Nurse Clinicians /economics; Outcome and Process Assessment (Health Care); Patient Care Team /economics; Patient Satisfaction; Prostatic Neoplasms (...) population Men with newly diagnosed or previously known prostate cancer in any stage were eligible for the study but the disease must have been judged to be clinically stable with an expected survival of more than three months. The exclusion criteria were: patients considered for curative treatment; patients participating in a trial that stipulated a specific follow-up protocol; or patients with psychiatric disorders or those whose general condition had deteriorated. Setting The study setting

recurrence of prostate cancer, asymptomatic distant metastases, symptomatic distant metastases, and death. Patients experiencing severe side effects or disease progression were switched to a second-line therapy. Each cycle lasted one month and transition probability data were derived from the literature. Outcomes assessed in the review The outcomes assessed in the review were used as inputs in the model. These were the efficacy (base-case and meta-analysis estimates) and toxicity of antiandrogen (...) of the strategies was clear. The six therapies were selected as they represented feasible interventions for patients with advance prostate cancer. However, it was unclear what the incremental cost-effective ratio of DES over no treatment was, although presumably the costs of treating disease not remedied by DES outweigh the cost of the DES itself. You should assess whether they represent widely used therapies in you own setting. Validity of estimate of measure of effectiveness The effectiveness analysis used

Prostate cancer staging: should MR imaging be used? A decision analytic approach Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

Brachytherapy for the treatment of prostate cancer Brachytherapy for the treatment of prostate cancer Brachytherapy for the treatment of prostate cancer Medical Services Advisory Committee 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 Medical Services Advisory Committee. Brachytherapy for the treatment of prostate cancer. Canberra (...) : Medical Services Advisory Committee (MSAC) 2000: 45 Authors' objectives This report aims to assess the effectiveness of brachytherapy for prostate cancer. Authors' conclusions MSAC recommends that from the evidence pertaining to brachytherapy for the treatment of prostate cancer, interim public funding should be supported for patients with prostate cancer: - at clinical stages T1, T2a or T2b, with Gleason Scores of less than or equal to 6, prostate specific antigen (PSA) of less than or equal to 10 ng

the available evidence on the effectiveness of brachytherapy for prostate cancer. Authors' conclusions The intermediate short-term results of brachytherapy (biochemical control levels and disease-free survival) for patients selected with a low risk of extraprostatic progression seem to be comparable to those of other therapeutic options, such as prostatectomy and external radiotherapy. There are no long-term data available, despite the fact that the results of a sample (n=77) followed up for 12 years were (...) of AST) with patients presenting prior irradiation of the pelvis, severe urethral obstruction and transurethral prostatic resection excluded. There is uncertainty with regard to localised prostate cancer (PC). Despite the fact that there is evidence that this type of tumour tends to present a slow progression, it is not clear whether the type of treatment will or will not help all men with PC to live longer. On the other hand it must be remembered that treatments can affect patient quality of life

. However, complications appear to be much less frequent with brachytherapy. In summary, this technology remains experimental until data are available to confirm its efficacy, particularly among men with localised, well-differentiated early stage prostate cancer with low pre-treatment PSA levels. Project page URL Indexing Status Subject indexing assigned by CRD MeSH Brachytherapy; Prostatic Neoplasms; Radiotherapy Language Published English, French Country of organisation Canada Province or state Quebec (...) Brachytherapy and prostate cancer Brachytherapy and prostate cancer Brachytherapy and prostate cancer Conseil d'Evaluation des Technologies de la Sante du Quebec 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 Conseil d'Evaluation des Technologies de la Sante du Quebec. Brachytherapy and prostate cancer. Montreal: Conseil d'Evaluation des

, Cherlow J, Perley J, Tansey L et al. Temporary iridium-192 implant in the management of carcinoma of the prostate. Cancer 1992;69(10):2515-24. Stromberg J, Martinez A, Gonzalez J, Edmundson G, Ohanian N, Vicini F et al. Ultrasound-guided high dose rate conformal brachytherapy boost in prostate cancer: treatment description and preliminary results of a phase I/II clinical trial. Int J Radiat Oncol Biol Phys 1995;33(1):161-71. Stromberg JS, Martinez AA, Horwitz EM, Gustafson GS, Gonzalez JA, Spencer WF (...) Brachytherapy for prostate cancer Brachytherapy for prostate cancer We use cookies on this website. By using this site, you agree that we may store and access cookies on your device. Swedish Agency for Health Technology Assessment and Assessment of Social Services Brachytherapy for prostate cancer Share: Reading time approx. 4 minutes This document was published more than 2 years ago. The nature of the evidence may have changed. Findings by SBU Alert This is a translation of version 1

Immediate hormonal therapy compared with observation after radical prostatectomy and pelvic lymphadenectomy in men with node-positive prostate cancer. Because the optimal timing of the institution of antiandrogen therapy for prostate cancer is controversial, we compared immediate and delayed treatment in patients who had minimal residual disease after radical prostatectomy.Ninety-eight men who underwent radical prostatectomy and pelvic lymphadenectomy and who were found to have nodal metastases (...) cancer in 3 men in the immediate-treatment group and in 16 men in the observation group (P<0.01). At the time of the last follow-up, 36 men in the immediate-treatment group (77 percent) and 9 men in the observation group (18 percent) were alive and had no evidence of recurrent disease, including undetectable serum prostate-specific antigen levels (P<0.001). In the observation group, the disease recurred in 42 men; 13 of the 36 who were treated had a complete response to local treatment or hormonal

to lessen the risk of radiation-related effects in a randomised controlled trial of conformal versus conventional radiotherapy.We recruited men with prostate cancer for treatment with a standard dose of 64 Gy in daily 2 Gy fractions. The men were randomly assigned conformal or conventional radiotherapy treatment. The primary endpoint was the development of late radiation complications (> 3 months after treatment) measured with the Radiation Therapy and Oncology Group (RTOG) score. Indicators of disease (...) in local tumour control (conformal 78% [95% CI 66-86], conventional 83% [69-90]).Conformal techniques significantly lowered the risk of late radiation-induced proctitis after radiotherapy for prostate cancer. Widespread introduction of these radiotherapy treatment methods is appropriate. Our results are the basis for dose-escalation studies to improve local tumour control.

with prostate cancer (various clinical stages of disease and previous treatments). Outcomes assessed in the review Studies reporting patient outcomes (not specified) were preferred. Outcomes reported in the review include: biochemical outcomes (prostate specific antigen levels), clinical outcomes (DRE, biopsy, bone scans, CT scans), survival and complications. How were decisions on the relevance of primary studies made? The results of the literature search were first screened by title, then by abstract (...) Brachytherapy for prostate cancer Brachytherapy for prostate cancer Brachytherapy for prostate cancer Wills F, Hailey D Authors' objectives To review the effectiveness of brachytherapy for prostate cancer. Searching MEDLINE (1997 to Aug 1999, the Cochrane Library (latest version), Cancerlit (1997 to Aug 1999), EMBASE (1997 to April 1999), HealthSTAR (1992 to Aug 1999) and CINAHL (1997 to April 1999) were searched (search terms listed). In addition, the reference lists of retrieved articles were

The diagnostic value of digital rectal examination in primary care screening for prostate cancer: a meta-analysis The diagnostic value of digital rectal examination in primary care screening for prostate cancer: a meta-analysis The diagnostic value of digital rectal examination in primary care screening for prostate cancer: a meta-analysis Hoogendam A, Buntinx F, de Vet H C Authors' objectives To systematically review the literature in order to examine the diagnostic value of digital rectal (...) examination (DRE) for the diagnosis of prostate cancer in a primary care setting. Searching MEDLINE was searched from 1993 to 1995. FAMLI, a specialist family practice database, was also searched but no search dates were given. Some general practice journals were handsearched. The reference lists of the included studies were checked for additional citations. No language restrictions were reported. Study selection Study designs of evaluations included in the review Diagnostic accuracy studies were eligible

for monotherapy, or comparing monotherapy with combined androgen blockade, were included if they enrolled men with advanced prostate cancer who had not been previously treated with hormonal therapy for prostate cancer. Advanced prostate cancer was defined as either those with disseminated and/or symptomatic metastases (defined as stage D1/D2, N+ or M1 disease), or those with asymptomatic or minimally advanced disease (defined as stage C or T3-4NxMO disease). For trials comparing immediate and deferred (...) after definitive therapy to androgen suppression deferred until clinical signs or symptoms of progression. For patients newly diagnosed with locally advanced or asymptomatic metastatic disease, the evidence is insufficient to determine whether primary androgen suppression initiated immediately at diagnosis improves outcomes compared to androgen suppression deferred until clinical signs or symptoms of progression. For patients with locally advanced or asymptomatic metastatic prostate cancer who

was given both pre and post radiotherapy. Radiotherapy doses ranged from 60 to 79 Gy. Participants included in the review Patients with variable stages and grades of localised prostate cancer were studied. Outcomes assessed in the review Indicators of local, regional and biochemical control were assessed including biopsy results, disease free survival, and overall survival. How were decisions on the relevance of primary studies made? The authors do not state how the papers were selected for the review (...) of patients by prognostic factors; possibility of under detection of cancer cells as a result of morphological changes induced by androgen ablation; degree of correlation of pathological findings with clinical outcome; and problems with the accuracy of defining disease status in patients at the time of death. By limiting the literature search to articles published in the English language and identified in MEDLINE, some other relevant studies may have been omitted. The inclusion criteria do not include

in the treatment of prostate cancer. Searching MEDLINE (January 1, 1985 to August 1, 1998) was searched for articles published in the English language. The MeSH terms used were 'prostatic neoplasms', 'prostatic neoplasms brachytherapy', 'prostatic neoplasms interstitial brachytherapy', and 1985 to 1998. Study selection Study designs of evaluations included in the review Any study that reported on prostate cancer treatment using brachytherapy and presented evaluable treatment results. Literature reviews were (...) A comprehensive review of prostate cancer brachytherapy: defining an optimal technique A comprehensive review of prostate cancer brachytherapy: defining an optimal technique A comprehensive review of prostate cancer brachytherapy: defining an optimal technique Vicini F A, Kini V R, Edmundson G, Gustafson G S, Stromberg J, Martinez A Authors' objectives To determine if an optimal method of implantation could be identified, and to compare and contrast techniques currently in use for brachytherapy