Estimation of the optimal utilisation rates of radical prostatectomy, external beam radiotherapy and brachytherapy in the treatment of prostate cancer by a review of clinical practice guidelines

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
Stephen R ThompsonM B Barton

Abstract

We aimed to construct an evidence-based model of optimal treatment utilisation for prostate cancer, incorporating all local treatment modalities: radical prostatectomy (RP), external beam radiotherapy (EBRT), and brachytherapy (BT); and then to compare this optimal model with actual practice. Evidence-based guidelines were used to construct a prostate cancer treatment decision-tree. The proportion of patients who fulfilled treatment criteria was drawn from the epidemiological literature. These data were combined to calculate the overall proportion of patients that should optimally have RP, EBRT and/or BT at least once during the course of their disease. The model was peer reviewed and tested by sensitivity analyses and compared with actual practice. Optimal utilisation rates, at some point during the disease course, were: RP, 24% (range 15-30%); EBRT, 58% (range 54-64%); BT, 9.6% (range 6.0-17.9%); and any RT, 60% (range 56-66%). Many patients had indications for more than one of these treatments, and at least one of these treatments was indicated in 76% of patients. The model was sensitive to patient preference estimates. Optimal rates were achievable in some health care jurisdictions. Modelling optimal utilisation of all loca...Continue Reading

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Citations

Jul 28, 2016·Journal of Medical Imaging and Radiation Oncology·Andrej Bece, Joseph Bucci
Aug 8, 2018·European Journal of Cancer Care·Margaret M HaighSandra C Thompson
Jan 13, 2018·The British Journal of Radiology·Jarad M MartinCharles N Catton
Oct 21, 2016·Physiological Research·M HrubýP Štěpánek
Aug 15, 2021·Nature Reviews. Urology·Michael YanFabio Y Moraes

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