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Additional file 1: Table SA1. Baseline cardiovascular disease risk factor by treatment group. Table SA2. Baseline drug use and surgery/intervention for IHD by treatment group. Table SA3. Multivariable logistic regression of receiving RT + ADT treatment. Table SA4. Univariate and multivariable analysis of MACE after start of treatment with treatment propensity score included as a covariate. Table SA5. Univariate and multivariable analysis of MACE after start of treatment with treatment propensity score weighting. Table SA6. Cumulative Incidence Rate of Mortality by Causes. Table SA7. MACE by Type of Event.

To report the long-term clinical outcomes of low-risk (LR) and intermediate-risk (IR) prostate cancer patients treated with low-dose-rate brachytherapy (LDR-BT) and external beam radiation therapy (EBRT). Men with biopsy-proven low- and intermediate-risk prostate cancer received EBRT and LDR-BT in an Asian academic center from 2000 to 2019 were reviewed. Kaplan–Meier survival analysis was performed to compare biochemical failure-free survival (bFFS) and overall survival (OS) between LDR and EBRT in the low- and intermediate-risk cohorts. 642 patients (521 EBRT and 121 LDR-BT) with low- and intermediate-risk prostate cancer were included for analysis. In the intermediate-risk group, 5- and 10-year bFFS was 96%, 89% and 86%, 61% for LDR-BT and EBRT, respectively. LDR-BT was associated with a statistically significant improvement of bFFS in the intermediate-risk cohort (HR 2.7, p = 0.02). In the low-risk cohort, no difference of bFFS was found between LDR-BT and EBRT (HR 1.9, p = 0.08). Hormone therapy was more common in EBRT than LDR-BT for intermediate-risk group (71% versus 44%, p p = 0.2 and HR = 1.7, p = 0.3). In our retrospective study, LDR-BT is associated with superior bFFS compared with EBRT in Asian men with intermediate-risk prostate cancer.