{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T03:16:41Z","timestamp":1781839001239,"version":"3.54.5"},"reference-count":23,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Stereotactic body radiotherapy (SBRT) and high\u2013dose-rate brachytherapy monotherapy (HDR-BT) are options for intermediate-risk prostate cancer. However, no prospective evidence is available to compare these modalities.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare the biochemical failure (BCF), late patient-reported quality of life (PR-QoL), and acute and late adverse events (AEs) associated with SBRT and HDR-BT using prospective data.<\/jats:p>\n <\/jats:sec>\n \n Data Sources<\/jats:title>\n This was an individual patient data post hoc pooled analysis of 5 prospective trials with recruitment from 2010 to 2018. Statistical analyses were performed in September 2024.<\/jats:p>\n <\/jats:sec>\n \n Study Selection<\/jats:title>\n This was a post hoc analysis of these 5 sprospective trials. Eligibility criteria comprised men with intermediate-risk prostate cancer undergoing 5- or 2-fraction SBRT or 2-fraction HDR-BT. No androgen deprivation therapy was permitted.<\/jats:p>\n <\/jats:sec>\n \n Data Extraction and Synthesis<\/jats:title>\n Baseline patient and clinicopathological characteristics were requested.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n BCF, a minimal clinically important change on the PR-QoL, and clinician-reported AEs were the main outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n After a median (IQR) follow-up of 9.5 (5.5-10.6) years, 247 men met the eligibility criteria, including 180 men undergoing SBRT (72.8%; mean [SD] age, 69.5 [6.7] years) and 67 men undergoing HDR-BT (27.1%; mean [SD] age, 66.0 [6.5] years). HDR-BT was associated with increased BCF. At 5 years, BCF was 7.8% (95% CI, 1.0%-14.6%) for HDR compared with 3.0% (95% CI, 0.4%-5.6%) for SBRT. At 10 years, BCF was 38.0% (95% CI, 19.8%-56.1%) for HDR compared with 10.4% (95% CI, 4.3%-16.6%) for SBRT (\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). The HDR-BT cohort had a significantly higher incidence of acute grade 2 or greater genitourinary AEs compared with SBRT (50 men [74.6%] vs 31 men [51.7%];\n P<\/jats:italic>\n \u2009=\u2009.007). There were no significant differences in any other acute or late AEs or late PR-QoL.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This post hoc pooled analysis reports a long-term comparison of SBRT and HDR-BT using prospective data. SBRT had significantly lower BCF and acute genitourinary AEs, and there was no significant difference in late PR-QoL.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.0146","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T16:30:35Z","timestamp":1772037035000},"page":"e260146","source":"Crossref","is-referenced-by-count":2,"title":["SBRT vs HDR Brachytherapy for Intermediate-Risk Prostate Cancer"],"prefix":"10.1001","volume":"9","author":[{"given":"Cristian","family":"Udovicich","sequence":"first","affiliation":[{"name":"Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada"},{"name":"GenesisCare Radiation Oncology, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Cheung","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Chu","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Chung","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Detsky","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, 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University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danny","family":"Vesprini","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Hudson","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wee Loon","family":"Ong","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada"},{"name":"Alfred Health Radiation Oncology, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada"},{"name":"BC Cancer, Kelowna, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joelle","family":"Helou","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada"},{"name":"Division of Radiation Oncology, Verspeeten Family Cancer Center, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Davidson","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada"},{"name":"BC Cancer, Kelowna, British Columbia, Canada"},{"name":"Computer Science, Mathematics, Physics and Statistics Department, University of British Columbia Okanagan, Kelowna, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ananth","family":"Ravi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merrylee","family":"McGuffin","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Mamedov","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Deabreu","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Kulasingham-Poon","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, 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