Key clinical point: External beam radiation therapy (EBRT) plus a high-dose rate brachytherapy boost (BB) for the treatment of prostate cancer was not associated with worse functional outcomes or health-related quality of life compared with EBRT alone.

Major finding: EBRT-BB was found to be non-inferior to EBRT alone for the urinary incontinence, sexual, bowel and hormonal domains of Expanded Prostate Cancer Index Composite-26.

Study details: The study included patients diagnosed with intermediate-risk, high-risk or locally advanced prostate cancer, who received EBRT in the NHS within 18 months of diagnosis and responded to a national patient questionnaire (n = 13,259).

Disclosures: The study was supported by the National Institute for Health Research and the Medical Research Council. B Berry, H Payne and J van der Meulen received individual grants/support various organizations.

Commentary

“Advances in radiotherapy continue to provide potential treatment options for patients with localized prostate cancer; however, which strategy to utilize is an ongoing question. Previous trials and observational studies have suggested that a local radiation brachytherapy boost (BB) may be associated with improvements in biochemical control, time to distant metastasis, and survival. However, functional outcomes need to be balanced against potential benefits. Parry et al. describe patient-reported outcomes obtained via surveys in patients with higher risk disease who underwent external beam radiation (EBRT) with or without a brachytherapy boost (EBRT-BB). Overall, EBRT-BB was non-inferior compared with EBRT with respect to clinically important urinary, sexual, bowel, and hormonal function. This is the first large scale study to report all these outcomes and suggests that functional outcomes of EBRT-BB are likely to be as tolerable as those of EBRT alone.”

Mark Klein, MD