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Volume 67, Issue 3, Pages 812-822 (1 March 2007)


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Brachytherapy versus prostatectomy in localized prostate cancer: Results of a French multicenter prospective medico-economic study

Catherine Buron, Ph.D., Beatrice Le Vu, M.D., Jean-Marc Cosset, M.D., Pascal Pommier, M.D., Ph.D., Didier Peiffert, M.D.§, Martine Delannes, M.D., Thierry Flam, M.D., Stephane Guerif, M.D., Ph.D.#, Naji Salem, M.D.⁎⁎, Laurent Chauveinc, M.D., Ph.D.††, Alain Livartowski, M.D.Corresponding Author Informationemail address

Received 21 April 2006; received in revised form 20 September 2006; accepted 4 October 2006.

Purpose: To prospectively compare health-related quality of life (HRQOL), patient-reported treatment-related symptoms, and costs of iodine-125 permanent implant interstitial brachytherapy (IB) with those of radical prostatectomy (RP) during the first 2 years after these treatments for localized prostate cancer.

Methods and Materials: A total of 435 men with localized low-risk prostate cancer, from 11 French hospitals, treated with IB (308) or RP (127), were offered to complete the European Organization for Research and Treatment of Cancer core Quality of Life Questionnaire QLQ-C30 version 3 (EORTC QLQ-C30) and the prostate cancer specific EORTC QLQ-PR25 module before and at the end of treatment, 2, 6, 12, 18, and 24 months after treatment. Repeated measures analysis of variance and analysis of covariance were conducted on HRQOL changes. Comparative cost analysis covered initial treatment, hospital follow-up, outpatient and production loss costs.

Results: Just after treatment, the decrease of global HRQOL was less pronounced in the IB than in the RP group, with a 13.5 points difference (p < 0.0001). A difference slightly in favor of RP was observed 6 months after treatment (−7.5 points, p = 0.0164) and was maintained at 24 months (−8.2 points, p = 0.0379). Impotence and urinary incontinence were more pronounced after RP, whereas urinary frequency, urgency, and urination pain were more frequent after IB. Mean societal costs did not differ between IB (€8,019 at T24) and RP (€8,715 at T24, p = 0.0843) regardless of the period.

Conclusions: This study suggests a similar cost profile in France for IB and RP but with different HRQOL and side effect profiles. Those findings may be used to tailor localized prostate cancer treatments to suit individual patients’ needs.

 Department of Medical Information, Institut Curie, Paris, France

 Department of Oncology/Radiotherapy, Institut Curie, Paris, France

 Department of Radiotherapy, Centre Leon Berard, Lyon, France

§ Department of Radiotherapy, Centre Alexis Vautrin, Nancy, France

 Department of Radiotherapy, Centre Claudius Regaud, Toulouse, France

 Department of Urology, Hôpital Cochin, Paris, France

# Department of Radiotherapy, Centre Hospitalier Universitaire, Poitiers, France

⁎⁎ Department of Radiotherapy, Institut Paoli-Calmettes, Marseille, France

†† Department of Radiotherapy, Clinique Hartmann, Neuilly sur Seine, France

Corresponding Author InformationReprint requests to: Alain Livartowski, M.D., Department of Medical Information, Institut Curie, 25 rue d’Ulm, 75005 Paris, France. Tel: (+33) 1-4432-4683; Fax: (+33) 1-5310-4039

 Supported by a grant from the French Ministry of Health STIC 2000.

 Conflict of interest: none.

PII: S0360-3016(06)03247-0

doi:10.1016/j.ijrobp.2006.10.011


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