Comparative Evaluation of Radiation Treatments for Clinically Localized Prostate Cancer: an Update [Internet]

Excerpt

The Coverage and Analysis Group at the Centers for Medicare and Medicaid Services (CMS) requested this report from The Technology Assessment Program (TAP) at the Agency for Healthcare Research and Quality (AHRQ). AHRQ assigned this report to the following Evidence-based Practice Center: Tufts EPC (Contract No. 290 2007 10055 I).

Prostate cancer is the most common noncutaneous malignancy diagnosed in men in the United States. The vast majority of patients diagnosed today have clinically localized prostate cancer (T1-T2N0), which is the subject of this report. A Comparative Effectiveness Review of Therapies for Clinically Localized Prostate Cancer was undertaken on behalf of the Agency for Healthcare Research and Quality (AHRQ) by the Minnesota Evidence-based Practice Center (EPC) in 2007 (Wilt et al. Comparative effectiveness of therapies for clinically localized prostate cancer. Comparative Effectiveness Review No. 13, prepared by Minnesota Evidence-based Practice Center under contract no. 290-02-0009 Rockville, MD: Agency for Healthcare Research and Quality, February 2008. Available at effectivehealthcare.ahrq.gov/reports/final.cfm). The report concluded that “No one therapy can be considered the preferred treatment for localized prostate cancer due to limitations in the body of evidence as well as the likely tradeoffs an individual patient must make between estimated treatment effectiveness, necessity, and adverse effects. All treatment options result in adverse effects (primarily urinary, bowel, and sexual), although the severity and frequency may vary between treatments. Even if differences in therapeutic effectiveness exist, differences in adverse effects, convenience, and costs are likely to be important factors in individual patient decision making.” As more studies on radiation treatments have been published since the Minnesota report, the Centers for Medicare and Medicaid Services (CMS) is interested in an update. After consultation with AHRQ and CMS, this technology assessment has been commissioned specifically to examine the recent comparative studies on radiation treatments of clinically localized prostate cancer.