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Current results of the two-year SPIRIT study demonstrate clear advantages for brachytherapy
Higher quality of life, hardly any incontinence and better erectile function. The latest results of the SPIRIT study show clear advantages of brachytherapy over radical removal of the prostate in patients with localized prostate cancer. Brachytherapy is also far superior to surgery in terms of patient satisfaction.
In patients with prostate cancer, brachytherapy, external beam radiation and surgery each lead to equal cure rates, provided the tumor is detected early. This has already been clearly demonstrated in numerous studies1. In contrast, data on quality of life in successfully treated patients are very scarce. "When choosing the appropriate therapy, we need to think not only about the cure rate, but also about the impact of the treatment on the quality of life of those affected," demands Dr. Pedram Derakhshani, urologist at the West German Prostate Center.
Recently, a large-scale study2 compared brachytherapy and surgical removal of the prostate in terms of health-related quality of life using standardized questionnaires. Questions were asked about bladder emptying (micturition) and continence, erectile function, bowel dysfunction, effects of hormonal treatment, and patient satisfaction. No differences between the two forms of therapy were found, however, for the bowel- and hormone-specific questions.
The results show that factors that are important for quality of life after therapy are clearly more positive with brachytherapy than with radical surgery. For example, the study showed that brachytherapy impairs sexuality less and leads to urinary incontinence less frequently than radical removal of the prostate.
"The results are in line with the guidelines of the German Society of Urology (DGU)," explains Dr. Derakhshani. These state that prostate cancer patients who receive brachytherapy suffer significantly less frequently from impairment of their potency after treatment than patients after surgery. Urinary incontinence, which is as high as 50 percent after radical removal of the prostate, is also negligible at 0.3 to 3 percent after seed implantation and really only occurs after previous prostate resection (TURP).
