In patients with localised prostate cancer, indications exist (based on data from non-randomised observational studies) of an advantage of brachytherapy vs. radical prostatectomy concerning impairment of sexual function and urinary incontinence. With regard to rectal function, this also applies to the comparison between brachytherapy and percutaneous radiotherapy.
In respect of overall survival, as well as disease-specific and disease-free survival, no evidence is available to demonstrate a superiority or equivalence of brachytherapy versus prostatectomy or radiotherapy.
Therefore, the potential advantages of brachytherapy with regard to organ function and quality of life in patients with localised prostate cancer as the only evidence of a benefit are insufficient to apply this therapeutic procedure, as potential harm regarding survival and disease-related symptoms cannot be excluded with sufficient certainty. We therefore urgently recommend the conduct of sound clinical studies in order to define the relevance of brachytherapy compared with other treatment options.