Objective: To use the Surveillance, Epidemiology, and End Results (SEER) registry to analyze age-specific time trends in the use of radiotherapy (RT) (external beam radiotherapy [EBRT], brachytherapy [brachy], and combination therapy [combo]) as first-line treatment for prostate cancer.
Methods: A total of 820,649 prostate cancer patients in the SEER public-use registry (1973-2004) with diagnosis year, treatment, and age information available were identified. Modality use time-trend curves were plotted for patients 45 to 85+ years of age, grouped in 5-year intervals. A nonparametric (Spearman) test was used to assess the correlation between diagnosis year and (a) percentage use of RT and (b) relative percentage use of EBRT, brachy, and combo therapy.
Results: Over the study period from 1973 to 2004, RT use increased in patients ≥65 years of age, but has remained stable in patients <65 years of age. All age groups experienced a similar relative rise in the use of brachy and combo therapy, with brachy use surpassing combo use in approximately year 2000.
Conclusions: Trends in treatment choice for early prostate cancer generally reflect treatment advances, but do not appear to be uniform among all age groups. The SEER database is a valuable asset for analyzing these trends and can be used to investigate age-specific treatment patterns.