ORIGINAL RESEARCH article
Front. Urol.
Sec. Urologic Oncology
Volume 5 - 2025 | doi: 10.3389/fruro.2025.1598726
High-Dose-Rate Brachytherapy Lowers Travel Burden for Man with Localized Prostate Cancer Compared with External Beam Radiation
Provisionally accepted
- 1School of Medicine and Dentistry, University of Rochester, Rochester, New York, United States
- 2Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, United States
- 3Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York, United States
- 4Radiation Oncology, University of Rochester, Rochester, New York, United States
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Objective: There are many treatment options for localized prostate cancer, including external beam radiation therapy (EBRT), stereotactic body radiation therapy (SBRT), or prostate brachytherapy (BT). This study aimed to compare the travel burden of high-doserate brachytherapy (HDR-BT) at our brachytherapy center and EBRT or SBRT if treated close to home. Materials and methods: This single institution retrospective cohort study included 69 patients who had HDR-BT monotherapy for their prostate cancer from August 2017 to December 2022. The travel burden for HDR-BT monotherapy was estimated using Google Maps by measuring the distance from each patient's home address to our BT center. The total travel burden was calculated by multiplying the number of treatment fractions required for each modality by the roundtrip travel distance between the home and treatment facility. Treatment toxicity was evaluated using the Expanded Prostate Index Composite for Clinical Practice (EPIC-CP) questionnaire. Results: The median age of the 69 patients was 67 years. The mean distance from home to the brachytherapy center was 37.4 miles, while the mean distance to the nearest radiation facility was 8.3 miles. The mean total travel distance for HDR-BT was 150 miles, compared to 463 miles for EBRT and 83 miles for SBRT. HDR-BT resulted in a mean travel burden reduction of 313 miles compared to EBRT. EPIC-CP scores indicated minimal posttreatment toxicity, with most patients reporting stable or improved symptoms. Conclusion: HDR-BT monotherapy significantly reduces travel burden compared to EBRT for localized prostate cancer, with minimal treatment-associated toxicity. Increasing the availability of brachytherapy centers could further alleviate travel burdens. Alternatively, providing transportation support could improve access to care.
Keywords: prostate cancer, High-dose-rate brachytherapy, External beam radiation therapy, patient travel burden, access to care
Received: 24 Mar 2025; Accepted: 06 Jun 2025.
Copyright: © 2025 Liu, Yang, Bylund, Cummings and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hong Zhang, Radiation Oncology, University of Rochester, Rochester, New York, United States
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