Comparison of high-dose proton radiotherapy and brachytherapy in XXXX : a case-matched analysis.

@entity1 @entity263 @entity7279 @entity1486
PURPOSE: To report a case-matched analysis comparing high-dose external-beam radiation (EBRT) for @entity263 delivered on Proton Radiation Oncology Group (PROG) 95-09, a randomized trial, with permanent prostate brachytherapy over the same era. METHODS: From 1996 to 1999, 196 @entity1 were accrued to the high-dose arm (79.2 Gray equivalent (GyE) using photons and protons) of PROG 95-09 at the Massachusetts General Hospital and Loma Linda University Medical Center. Entry criteria specified @entity7279 and @entity1486  <= 15 ng/mL. When Gleason score >7 was excluded, 177 @entity1 were left for case matching. At Massachusetts General Hospital, 203 similar @entity1 were treated by a single brachytherapist from 1997 to 2002. Minimum follow-up was 3 years. Case matching, based on T stage, Gleason score, @entity1486 , and age resulted in 141 matches (282 @entity1 ). Median follow-up was 8.6 and 7.4 years for EBRT and brachytherapy, respectively. The primary endpoint was biochemical failure (BF). RESULTS: Using the Phoenix definition, the 8-year BF rates were 7.7% and 16.1% for EBRT and brachytherapy, respectively (p = 0.42). A stratified analysis was performed by risk group. In the EBRT group, 113 and 28 @entity1 were low and intermediate risk, respectively. In the brachytherapy group, 118 and 23 were. When stratified by risk group, the BF rates were similar by either technique. CONCLUSIONS: High-dose EBRT and brachytherapy result in similar BF rates for @entity1 with @entity263 . Comparative quality-of-life and cost-effectiveness studies are warranted.
