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A trial looking at external radiotherapy with or without internal radiotherapy for prostate cancer
This trial compared external radiotherapy alone with external radiotherapy followed by internal radiotherapy (brachytherapy) for localised prostate cancer.
Doctors often treat prostate cancer with external radiotherapy. But they wanted to find out if using a combination of external radiotherapy and internal radiotherapy (brachytherapy) was better than external radiotherapy alone.
In this trial, one group of patients had external radiotherapy. The other group had a lower dose of external radiotherapy followed by a dose of internal radiotherapy. The aim of the trial was to see which is better at treating prostate cancer.
Summary of results
The research team found that a combination of external and internal radiotherapy was useful for treating localised prostate cancer.
The trial recruited over 200 men with prostate cancer, aged between 47 and 80 years. Half the men had external radiotherapy alone, and half had both external and internal radiotherapy.
When the researchers analysed the results in 2007, they found that men who’d had external radiotherapy alone had a rise in their PSA blood level tests sooner than those who’d had both types of radiotherapy.
In the quality of life study, men who’d had both external and internal radiotherapy rated their quality of life more highly 3 months after finishing treatment. Fewer had rectal side effects, such as discharge from the rectum.
The research team did more analysis in 2011. They looked at how long it was before the cancer started to grow again (recur) and found that there was a significant difference between the two groups. On average it was
- 6 years and 2 months in the group who'd had external radiotherapy alone
- 9 years and 8 months in the group who'd had both external and internal radiotherapy
But when they looked at how many men had died, they found that it was similar in both groups -
- 19 out of 106 men who had external radiotherapy alone
- 26 out of 110 men who had both external and internal radiotherapy
This difference was not big enough to be significant in statistical terms. There was also little difference in the number of men who had side effects that affected their bladder or bowel in the years after treatment.
The research team concluded that using both external and internal radiotherapy could be a useful treatment for prostate cancer. They suggest it is looked at in further trials, possibly using different doses.
We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed independently (
How to join a clinical trial
Dr Peter Hoskin
NHS Research and Development
National Institute for Health Research Cancer Research Network (NCRN)