PO71

Abstract

Purpose High-Dose-Rate Brachytherapy (HDR-BT) is an effective yet under-utilized treatment option for localized prostate cancer. Many studies have shown excellent long-term biochemical-failure-free survival outcomes with limited toxicity from HDR-BT as monotherapy for low- or intermediate-risk prostate cancer. However, due to higher start-up costs, less reimbursement, and inadequacy in residency training, far fewer radiation facilities are offering BT than external beam radiation (EBRT). Here, we performed a single-center, retrospective cohort study to evaluate the travel burdens put on patients who received BT as monotherapy at our high-volume center and if they had chosen external beam radiation close to home for localized prostate cancer. Materials and Methods From 1/1/2019 to 12/31/2022, 69 men were treated with HDR-BT as monotherapy at our brachytherapy center, receiving 27 Gy in 2 fractions, one week apart. Sixty-eight men had low- or intermediate-risk prostate cancer (Table). The travel burden for HDR-BT as monotherapy was estimated by collecting the distance between each patient's home address to our BT center (BT-D). The distance between each patient's home address and the nearest EBRT facility (EBRT-D) was also collected. The total travel burden for EBRT was then calculated, assuming a standard regiment of 28 fractions was used. Results Of the 69 patients who received BT for prostate cancer, the average age was 67.9 years, the overwhelming majority were white (96%), and all had insurance. The median and average EBRT-D were 5.5 and 8.3 miles, respectively. The median and average BT-D were 21 and 37.4 miles, respectively. However, due to the fewer visits required for BT (2 versus 28 trips), the total BT travel burden (median 84 miles, average 150.0 miles) was significantly less than for these patients if they had chosen EBRT instead (median 308 miles, average 462.5 miles) (p<0.01). On average, by choosing BT instead of EBRT, these patients reduced their travel burden by 312.5 miles. Conclusions We observed a significantly decreased overall travel burden for HDR-BT as monotherapy compared with EBRT in our cohort of patients with localized prostate cancer, despite a longer travel distance to our BT center than a nearby EBRT facility. Our study supports that HDR-BT as monotherapy remains a practical and preferred option for patients with localized prostate cancer, not only for its proven safety and efficacy but also decreased overall travel burden compared with definitive EBRT therapy. High-Dose-Rate Brachytherapy (HDR-BT) is an effective yet under-utilized treatment option for localized prostate cancer. Many studies have shown excellent long-term biochemical-failure-free survival outcomes with limited toxicity from HDR-BT as monotherapy for low- or intermediate-risk prostate cancer. However, due to higher start-up costs, less reimbursement, and inadequacy in residency training, far fewer radiation facilities are offering BT than external beam radiation (EBRT). Here, we performed a single-center, retrospective cohort study to evaluate the travel burdens put on patients who received BT as monotherapy at our high-volume center and if they had chosen external beam radiation close to home for localized prostate cancer. From 1/1/2019 to 12/31/2022, 69 men were treated with HDR-BT as monotherapy at our brachytherapy center, receiving 27 Gy in 2 fractions, one week apart. Sixty-eight men had low- or intermediate-risk prostate cancer (Table). The travel burden for HDR-BT as monotherapy was estimated by collecting the distance between each patient's home address to our BT center (BT-D). The distance between each patient's home address and the nearest EBRT facility (EBRT-D) was also collected. The total travel burden for EBRT was then calculated, assuming a standard regiment of 28 fractions was used. Of the 69 patients who received BT for prostate cancer, the average age was 67.9 years, the overwhelming majority were white (96%), and all had insurance. The median and average EBRT-D were 5.5 and 8.3 miles, respectively. The median and average BT-D were 21 and 37.4 miles, respectively. However, due to the fewer visits required for BT (2 versus 28 trips), the total BT travel burden (median 84 miles, average 150.0 miles) was significantly less than for these patients if they had chosen EBRT instead (median 308 miles, average 462.5 miles) (p<0.01). On average, by choosing BT instead of EBRT, these patients reduced their travel burden by 312.5 miles. We observed a significantly decreased overall travel burden for HDR-BT as monotherapy compared with EBRT in our cohort of patients with localized prostate cancer, despite a longer travel distance to our BT center than a nearby EBRT facility. Our study supports that HDR-BT as monotherapy remains a practical and preferred option for patients with localized prostate cancer, not only for its proven safety and efficacy but also decreased overall travel burden compared with definitive EBRT therapy.