Brachytherapy for Patients With Prostate Cancer: American Society of Clinical Oncology/Cancer Care Ontario Joint Guideline Update

Guideline Objective

This clinical practice guideline was produced jointly by the American Society of Clinical Oncology (ASCO) and Cancer Care Ontario (CCO). It updates the 2012 CCO guideline on brachytherapy for patients with prostate cancer. The update provides evidence-based recommendations for different patient risk groups, and specifies the most effective forms of brachytherapy. The joint guideline is published in the Journal of Clinical Oncology (JCO) and can be accessed directly from the link "Full Report" below.

Patient Population

Patients with newly diagnosed prostate cancer who require or choose active treatment and are not considering, or are not suitable for, active surveillance.

Intended Guideline Users

Radiation oncologists, urological surgeons, and other clinicians who provide care for patients defined by the target population.

Research Questions

1. In patients with newly diagnosed prostate cancer, what is the efficacy of brachytherapy alone for clinical outcomes compared with external beam radiation therapy (EBRT) alone or radical prostatectomy (RP) alone?
2. In patients with newly diagnosed prostate cancer, what is the efficacy of brachytherapy combined with EBRT for clinical outcomes compared with brachytherapy alone, EBRT alone, or RP alone?
3. Among the isotopes used for low–dose rate (LDR) brachytherapy (eg, iodine-125 [125I], palladium-103 [103Pd], and cesium-131 [131Cs]), which isotope maximizes clinical outcomes when used in patients with newly diagnosed prostate cancer?