Original Investigation

SBRT vs HDR Brachytherapy for Intermediate-Risk Prostate Cancer

JAMA Network Open 10.1001/jamanetworkopen.2026.0146

February 25, 2026 at 11:00 AM EST

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Is stereotactic body radiotherapy (SBRT) or high–dose-rate brachytherapy monotherapy (HDR-BT) associated with better outcomes in men with intermediate-risk prostate cancer?In this post hoc pooled analysis of 5 prospective trials among 247 men, HDR-BT was associated with worse biochemical failure and a significantly higher incidence of acute grade 2 or higher genitourinary adverse events vs SBRT.This is study’s long-term outcomes, including that SBRT was associated with decreased biochemical failure, may inform discussions regarding radiation modality selection for intermediate-risk prostate cancer.

Corresponding Author: Andrew Loblaw, MD, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada (andrew.loblaw@sunnybrook.ca).

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