Use of the newer, more expensive intensity-modulated radiotherapy (IMRT) and use of the older conformal radiotherapy (CRT) after surgical removal of all or part of the prostate gland were associated with similar morbidity and cancer control outcomes, according to a study published Online First by JAMA Internal Medicine, a JAMA Network publication.
Gregg H. Goldin, M.D., of the University of North Carolina at Chapel Hill, and colleagues analyzed data from the Surveillance, Epidemiology and End Results-Medicare-linked database to identify patients who received IMRT or CRT. The study included the outcomes of 457 IMRT and 557 CRT patients who received radiotherapy between 2002 and 2007.
The use of IMRT increased from zero in 2000 to 82.1 percent in 2009. Men who received IMRT vs. CRT showed no significant difference in rates of long-term gastrointestinal morbidity, urinary nonincontinent morbidity, urinary incontinence or erectile dysfunction. There also appeared to be no difference in subsequent treatment for recurrent disease, according to the study results.
"Our results provide new and important information to patients, physicians, and other decision makers on the currently available evidence regarding the outcomes of different postprostatectomy radiation techniques. The potential clinical benefit of IMRT compared with CRT in this setting is unclear," the study concludes.
(JAMA Intern Med. Published online May 20, 2013. doi:10.1001/jamainternmed.2013.1020. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor's Note: The authors made conflict of interest disclosures. The study was funded through a contract from the Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, as part of the DEcIDE program. Please see article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Journal
JAMA Internal Medicine