Brachytherapy treatment for prostate cancer is not a new venture to many clinicians. However, new, groundbreaking data is here to shed light on how brachytherapy is significantly improving patient outcomes.
ASCENDE-RT is the first ever controlled, randomized trial to compare low dose rate prostate brachytherapy (LDR-PB) to other forms of radiation treatment for prostate cancer. The study included 398 men with high or intermediate risk prostate (median age of 68 years). All of the men included in the study received 12 months of androgen deprivation therapy (ADT or hormone therapy), followed by 46 Gy of external beam radiation therapy to the whole pelvis in 23 fractions. After this initial treatment, 200 subjects were randomly assigned to receive an additional boost of dose-escalated EBRT (78 Gy) and 198 randomly assigned to receive an I-125 LDR-PB seed implant (115 Gy).
With the primary end-point of the study as biochemical progression-free survival, the ASCENDE-RT trial demonstrated a strong statistical improvement in outcomes for intermediate and high-risk prostate cancer patients when brachytherapy is combined with external beam radiation (EBRT) and hormone therapy (ADT) versus EBRT and hormone treatment alone. Furthermore, this improvement is validated by 5+ year follow-up in the study. Read the study here.
The ASCENDE-RT study is a strong argument for the use of a combined prostate cancer treatment course that includes brachytherapy, for high and intermediate patients.