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A comparative study of quality of life in patients with localized prostate cancer treated at a single institution: stereotactic ablative radiotherapy or external beam+high dose rate brachytherapy boost

Radiother Oncol. 2014 Dec;113(3):404-9. doi:

Radiother Oncol. 2014 Dec;113(3):404-9

Abstract

PURPOSE:

To compare the quality of life (QOL) in patients treated with stereotactic ablative radiation therapy (SABR) alone or high dose rate (HDR) brachytherapy+hypofractionated external beam radiotherapy (EBRT).

METHODS AND MATERIALS:

Patient self-reported QOL was prospectively measured among patients from two sequential phase 2 clinical trials: 1-SABR 35Gy/5fractions/5 weeks, 2-15Gy HDR 1 fraction, followed by EBRT 37.5Gy/15 fractions/3 weeks. The expanded prostate cancer index composite was assessed at baseline and q6 monthly up to 5 years. Urinary, bowel and sexual domains were analyzed. A minimally clinical important change (MCIC) was defined as 0.5*standard deviation of the baseline for each domain. Fisher exact test and general linear mixed model were used (p<0.05).

RESULTS:

84 and 123 patients were treated on the SABR and HDR boost studies, with a median follow up of 51 and 61 months respectively. There was a significant difference in MCIC between treatments in the urinary function and bother (p<0.0001), the bowel function (p=0.0216) and the sexual function (p=0.0419) and bother (p=0.0290) domains in favor of the SABR group. Of patients who reported no problem with their sexual function at baseline, 7% and 23% respectively considered it to be a moderate to big problem on follow up (p=0.0077).

CONCLUSION:

Patients treated with HDR-boost reported deterioration of QOL particularly in sexual domains in comparison with SABR.

Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

KEYWORDS:

High dose rate brachytherapy; Prostate cancer; Quality of life; Stereotactic ablative body radiotherapy

Comment from Henk van der Poel: Brachy boost for radiotherapy of prostate cancer resulted in worse bowel, urinary and sexual function outcome compared to stereotactive radiotherapy in 84 men. Long term oncological outcome comparison data are needed. Brachy boost for radiotherapy of prostate cancer resulted in worse bowel, urinary and sexual function outcome compared to stereotactive radiotherapy in 84 men. Long term oncological outcome comparison data are needed.

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