Brachytherapy is the implantation of radioactive sources in or near tumours. When used in the treatment of prostate cancer, radioisotopes are inserted directly into the prostate gland guided by a transrectal ultrasound probe as a single day-patient or overnight stay procedure. The radioactive sources have a localised effect and, when the placement and dosage are planned appropriately, destroy tumour cells of the prostate gland without significantly irradiating adjacent normal tissue. The total radiation dose is about twice that from conventional external beam radiotherapy (EBRT), and about 50 per cent higher in terms of biological equivalence.
There are two types of prostate brachytherapy permanent implants (using small iodine 125 (I 125) or palladium 103 (Pd 103) seeds) and temporary implants (using iridium 192 wires via temporary catheters). Only permanent implants using I 125 are the subject of this application. Palladium implants are not currently available in Australia.
Brachytherapy has been proposed to offer a more efficient treatment (shorter treatment, in-hospital and recovery time) for localised prostate cancer with the additional advantages of limiting the side-effects to adjacent tissues that occur with EBRT and the surgical risks associated with radical prostatectomy (RP). However, the procedure may be associated with short- and long-term complications.
Contents
Executive summary
Introduction
Background
The procedure
Intended purpose
Clinical need/burden of disease
Existing procedures
Comparators
Marketing status of the device/technology
Current reimbursement arrangement
Approach to assessment
Review of literature
Expert advice
Results of assessment
Is it safe?
Is it effective?
What are the economic considerations?
Conclusions
Safety
Effectiveness
Cost-effectiveness
Recommendation
Appendix A MSAC terms of reference and membership
Appendix B Advisory Panel
Appendix C Studies included in the review
Appendix D Defining the Clinical Question
Appendix E Estimated costs of brachytherapy treatment - translated from the United Kingdom and direct Australian estimates
Abbreviations
References.
Download: PDF Ebook
There are two types of prostate brachytherapy permanent implants (using small iodine 125 (I 125) or palladium 103 (Pd 103) seeds) and temporary implants (using iridium 192 wires via temporary catheters). Only permanent implants using I 125 are the subject of this application. Palladium implants are not currently available in Australia.
Brachytherapy has been proposed to offer a more efficient treatment (shorter treatment, in-hospital and recovery time) for localised prostate cancer with the additional advantages of limiting the side-effects to adjacent tissues that occur with EBRT and the surgical risks associated with radical prostatectomy (RP). However, the procedure may be associated with short- and long-term complications.
Contents
Executive summary
Introduction
Background
The procedure
Intended purpose
Clinical need/burden of disease
Existing procedures
Comparators
Marketing status of the device/technology
Current reimbursement arrangement
Approach to assessment
Review of literature
Expert advice
Results of assessment
Is it safe?
Is it effective?
What are the economic considerations?
Conclusions
Safety
Effectiveness
Cost-effectiveness
Recommendation
Appendix A MSAC terms of reference and membership
Appendix B Advisory Panel
Appendix C Studies included in the review
Appendix D Defining the Clinical Question
Appendix E Estimated costs of brachytherapy treatment - translated from the United Kingdom and direct Australian estimates
Abbreviations
References.
Download: PDF Ebook
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