Comments on: IMRT alone vs. HDR brachytherapy + IMRT — short-term outcomes are similar

By: Sitemaster

Sitemaster — Sat, 14 Nov 2009 17:37:01 +0000

Dear Roger: Please note that some of the data you ask about may be available in the full paper as opposed to just the abstract. Also, since this is a retrospective analysis, the "study design" was dependent upon the available data, and not on a prospective trial. Such retrospective analyses are commonly not able to provide insight into data that one might like to know about because the data may either not be available or they may be too difficult (or too expensive) to obtain.

By: Roger

Roger — Sat, 14 Nov 2009 08:18:37 +0000

I agree with Sitemaster. I remain amazed that in countless studies important information is often omitted. In this example, just how many patients were in each category of risk? And of course, how many patients had undergone ADT? Did any patients undergo HDR only? It appears not — and why not (this is considered an important standalone treatment option). As noted, 3-year biochemical survival rates are extremely short times in the treatment of prostate cancer. As is often reported, 5-year prostate cancer-specific survival rates are almost 100 percent in those men who are diagnosed as a result of PSA screening. In fact is often suggested that PSA screening gives a 5- to 10-year “jump” on the diagnoses of this disease cvompared to the pre-PSA days. One would think that in designing a time-consuming and possibly expensive study, more thought would go in to the design of same. This is not to belittle the effort, just a suggestion that a bit more thought might produce a more important outcome.

Roger

By: Sitemaster

Sitemaster — Fri, 13 Nov 2009 18:20:38 +0000

Dear Curt:

While that would seem to be true numerically, I suspect that, based on the numbers of high-risk patients included in this study, that difference is not statistically significant.

By: Curt

Curt — Fri, 13 Nov 2009 17:58:27 +0000

It would appear from the data that high-risk patients would benefit significantly from combined radiation treatment (93% vs 67%).