title: Stereotactic Ablative Radiotherapy Versus Low Dose Rate Brachytherapy or External Beam Radiotherapy: Propensity Score Matched Analyses of Canadian Data.
abstract: OBJECTIVE
  To compare biochemical failure-free survival (BFFS) and overall survival for prostate cancer treated with stereotactic ablative radiotherapy (SABR), low dose rate (LDR) brachytherapy or external beam radiotherapy (EBRT) using a large Canadian multi-institutional database.
  
  
  METHODS
  Patients with low risk localised prostate cancer treated with SABR, LDR or EBRT and no androgen deprivation therapy were selected. Propensity score matching was used to create two sets of matched cohorts with LDR and EBRT serving as control groups. Kaplan-Meier survival analysis and Cox proportional hazards regression were used to compare differences in BFFS and overall survival between treatment groups.
  
  
  RESULTS
  The pre-matched cohort contained 602 patients; the median follow-up was >5.0 years. There were no significant differences in BFFS before or after matching for SABR versus LDR but the prostate-specific antigen (PSA) nadir was lower after LDR. For the SABR versus EBRT, SABR had a BFFS trend before matching (P = 0.08), which became significant after matching (P < 0.001).
  
  
  CONCLUSIONS
  Using the Genitourinary Radiation Oncologists of Canada Prostate Cancer Risk Stratification database, low risk prostate cancer patients receiving SABR had similar BFFS compared with patients receiving LDR but better BFFS than EBRT patients. Further comparative studies of efficacy, quality of life and economic outcomes using a broader risk of patients are warranted.
authors: Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Health Policy, Measurement and Evaluation, University of Toronto, Toronto, Ontario, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Electronic address: andrew.loblaw@sunnybrook.ca.
authors: A
authors: A
authors: Loblaw
authors: Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
authors: T
authors: T
authors: Pickles
authors: Department of Radiation Oncology, British Columbia Cancer Agency, Kelowna, British Columbia, Canada.
authors: J
authors: J
authors: Crook
authors: Department of Radiation Oncology, L'Hotel Dieu de Quebec, Quebec City, Quebec, Canada.
authors: A-G
authors: AG
authors: Martin
authors: Department of Radiation Oncology, L'Hotel Dieu de Quebec, Quebec City, Quebec, Canada.
authors: E
authors: E
authors: Vigneault
authors: Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec, Canada.
authors: L
authors: L
authors: Souhami
authors: Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec, Canada.
authors: F
authors: F
authors: Cury
authors: Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
authors: J
authors: J
authors: Morris
authors: Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
authors: C
authors: C
authors: Catton
authors: Department of Radiation Oncology, Juravinski Cancer Centre, Hamilton, Ontario, Canada.
authors: H
authors: H
authors: Lukka
authors: Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors: P
authors: P
authors: Cheung
authors: Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors: P
authors: P
authors: Sethukavalan
authors: Department of Radiation Oncology, London Health Sciences Centre, London, Ontario, Canada.
authors: A
authors: A
authors: Warner
authors: Department of Radiation Oncology, London Health Sciences Centre, London, Ontario, Canada.
authors: Y
authors: Y
authors: Yang
authors: Department of Radiation Oncology, London Health Sciences Centre, London, Ontario, Canada; University of Western Ontario, London, Ontario, Canada.
authors: G
authors: G
authors: Rodrigues
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D002170:Canada; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D011788:Quality of Life; D016634:Radiosurgery / Q000379:methods*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000379:methods*; D012306:Risk
chemical_list: D017430:Prostate-Specific Antigen
keywords: Biochemical outcomes; brachytherapy; external beam radiotherapy; prostate cancer; stereotactic body radiotherapy