Partial or focal brachytherapy for prostate cancer: a systematic review and meta-analysis
Bibliographic record
Abstract
OBJECTIVES: Recent advances in image-guided brachytherapy have allowed for treatment volume reduction in the treatment of prostate cancer, with the aim to optimize disease control and reduce toxicities. This systematic review reports on the efficacy and safety of focal brachytherapy for treatment of patients with localized prostate cancer. METHODS: Medline, Embase, Web of Science, and Cochrane were searched from inception to July 2023. Studies were included if they reported on focal brachytherapy, and described either dosimetry or clinical outcomes in the monotherapy or salvage setting. Meta-analysis was conducted to estimate biochemical control (BC) at 12-60 months. The review protocol was registered on PROSPERO (CRD42022320921). RESULTS: Twenty-six studies reporting on 1492 patients were included in this review. Fourteen studies reported on monotherapy, 10 on salvage, and two on boost. The majority of studies used MRI and/or biopsy or PET for target identification, and MRI fusion and transrectal ultrasound (TRUS) for image guidance technique. BC for monotherapy was 97% (95% CI: 86%-99%) at 24 months and 82% (95% CI: 65%-92%) at 60 months. BC for salvage was 67% (95% CI: 62%-72%) at 24 months and 35% (95% CI: 17%-58%) at 60 months. Low rates of toxicity were reported across studies. CONCLUSIONS: Focal brachytherapy has promising efficacy and safety profiles. Future studies may compare focal brachytherapy to whole-gland treatments, to investigate relative efficacy and safety. ADVANCES IN KNOWLEDGE: In well-selected patients, partial or focal brachytherapy represents an evidence-based option with acceptable BC rates and a favourable toxicity profile.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.015 | 0.005 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".