title: Impact of brachytherapy on regional, racial, marital status, and age-related patterns of definitive treatment for clinically localized prostate carcinoma.
abstract: BACKGROUND
  The impact of the increased use of permanent prostate brachytherapy compared with other treatment modalities (such as radical prostatectomy and external-beam radiation therapy [EBRT]) for the treatment of clinically localized prostate carcinoma, and the previously reported regional, racial, and age-related variations in prostate carcinoma treatment, have not been well characterized to date. Therefore, the authors evaluated the impact of permanent prostate brachytherapy on the relative rates of the use of specific prostate carcinoma treatment modalities over time.
  
  
  METHODS
  Surveillance, Epidemiology, and End Results (SEER) cancer registry data from 1995 to 2000 were analyzed in a longitudinal, observational study utilizing bivariate and multivariate techniques.
  
  
  RESULTS
  Differential changes in the use of specific definitive treatment modalities were noted by region, age group, racial/ethnic group, and marital status. Increasing use of permanent prostate brachytherapy, with and without concomitant EBRT, was proportional to the decreasing use of radical prostatectomy alone and EBRT alone over time.
  
  
  CONCLUSIONS
  The current study revealed that permanent prostate brachytherapy appears to be replacing other treatment modalities in increasing numbers of clinically localized prostate carcinoma cases. Persistent regional, racial/ethnic, marital status, and age-related differences in the use of permanent prostate brachytherapy merit further investigation.
authors.affiliation: Department of Psychiatry, South Texas Veterans Health Care System, Audie L. Murphy Division, San Antonio, Texas, USA.
authors.forename: Laurel A
authors.initials: LA
authors.lastname: Copeland
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Elshaikh
authors.forename: James
authors.initials: J
authors.lastname: Jackson
authors.forename: Louis A
authors.initials: LA
authors.lastname: Penner
authors.forename: Willie
authors.initials: W
authors.lastname: Underwood
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D016001:Confidence Intervals; D018572:Disease-Free Survival; D006801:Humans; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D011336:Probability; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000208:ethnology / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D044469:Racial Groups / Q000706:statistics & numerical data*; D011879:Radiotherapy Dosage; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D018426:SEER Program; D013315:Stress, Psychological; D015996:Survival Rate; D016896:Treatment Outcome