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Title: External Beam Radiation Therapy or Brachytherapy With or Without Short-course Neoadjuvant Androgen Deprivation Therapy: Results of a Multicenter, Prospective Study of Quality of Life

Abstract

Purpose: The long-term effects of neoadjuvant androgen deprivation therapy (NADT) with radiation therapy on participant-reported health-related quality of life (HRQOL) have not been characterized in prospective multicenter studies. We evaluated HRQOL for 2 years among participants undergoing radiation therapy (RT) with or without NADT for newly diagnosed, early-stage prostate cancer. Methods and Materials: We analyzed longitudinal cohort data from the Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment Consortium to ascertain the HRQOL trajectory of men receiving NADT with external beam RT (EBRT) or brachytherapy. HRQOL was measured using the expanded prostate cancer index composite 26-item questionnaire at 2, 6, 12, and 24 months after the initiation of NADT. We used the χ{sup 2} or Fisher exact test to compare the shift in percentages between groups that did or did not receive NADT. Analyses were conducted at the 2-sided 5% significance level. Results: For subjects receiving EBRT, questions regarding the ability to have an erection, ability to reach an orgasm, quality of erections, frequency of erections, ability to function sexually, and lack of energy were in a significantly worse dichotomized category for the patients receiving NADT. Comparing the baseline versus 24-month outcomes, 24%, 23%, and 30% of participants receiving EBRT plusmore » NADT shifted to the worse dichotomized category for the ability to reach an orgasm, quality of erections, and ability to function sexually compared with 14%, 13%, and 16% in the EBRT group, respectively. Conclusions: Compared with baseline, at 2 years, participants receiving NADT plus EBRT compared with EBRT alone had worse HRQOL, as measured by the ability to reach orgasm, quality of erections, and ability to function sexually. However, no difference was found in the ability to have an erection, frequency of erections, overall sexual function, hot flashes, breast tenderness/enlargement, depression, lack of energy, or change in body weight. The improved survival in intermediate- and high-risk patients receiving NADT and EBRT necessitates pretreatment counseling of the HRQOL effect of NADT and EBRT.« less

Authors:
 [1];  [2]; ;  [3];  [4]; ;  [5];  [6];  [7];  [8];  [8];  [9];  [10];  [11];  [12];  [13];  [1]; ; ; more »; ; « less
  1. Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States)
  2. Department of Urology, Emory University School of Medicine, Atlanta, Georgia (United States)
  3. Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri (United States)
  4. Texas Center for Proton Therapy, Irving, Texas (United States)
  5. Department of Urology, University of Michigan, Ann Arbor, Michigan (United States)
  6. Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio (United States)
  7. Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California (United States)
  8. Department of Urology, University of California at Los Angeles, Los Angeles, California (United States)
  9. (United States)
  10. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
  11. Institute for Public Policy and Social Research, Michigan State University, East Lansing, Michigan (United States)
  12. Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts (United States)
  13. Department of Surgery, Beth Israel-Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (United States)
Publication Date:
OSTI Identifier:
22649928
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 98; Journal Issue: 2; Other Information: Copyright (c) 2017 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANDROGENS; BRACHYTHERAPY; EXTERNAL BEAM RADIATION THERAPY; MAMMARY GLANDS; NEOPLASMS; PROSTATE; RADIATION HAZARDS

Citation Formats

Gay, Hiram A., E-mail: hiramgay@wustl.edu, Sanda, Martin G., Liu, Jingxia, Wu, Ningying, Hamstra, Daniel A., Wei, John T., Dunn, Rodney L., Klein, Eric A., Sandler, Howard M., Saigal, Christopher S., Litwin, Mark S., Health Policy and Management, University of California at Los Angeles, Los Angeles, California, Kuban, Deborah A., Hembroff, Larry, Regan, Meredith M., Chang, Peter, Michalski, Jeff M., Regan, Meredith, Hembroff, Larry, Wei, John T., Hamstra, Dan, and and others. External Beam Radiation Therapy or Brachytherapy With or Without Short-course Neoadjuvant Androgen Deprivation Therapy: Results of a Multicenter, Prospective Study of Quality of Life. United States: N. p., 2017. Web. doi:10.1016/J.IJROBP.2017.02.019.
Gay, Hiram A., E-mail: hiramgay@wustl.edu, Sanda, Martin G., Liu, Jingxia, Wu, Ningying, Hamstra, Daniel A., Wei, John T., Dunn, Rodney L., Klein, Eric A., Sandler, Howard M., Saigal, Christopher S., Litwin, Mark S., Health Policy and Management, University of California at Los Angeles, Los Angeles, California, Kuban, Deborah A., Hembroff, Larry, Regan, Meredith M., Chang, Peter, Michalski, Jeff M., Regan, Meredith, Hembroff, Larry, Wei, John T., Hamstra, Dan, & and others. External Beam Radiation Therapy or Brachytherapy With or Without Short-course Neoadjuvant Androgen Deprivation Therapy: Results of a Multicenter, Prospective Study of Quality of Life. United States. doi:10.1016/J.IJROBP.2017.02.019.
Gay, Hiram A., E-mail: hiramgay@wustl.edu, Sanda, Martin G., Liu, Jingxia, Wu, Ningying, Hamstra, Daniel A., Wei, John T., Dunn, Rodney L., Klein, Eric A., Sandler, Howard M., Saigal, Christopher S., Litwin, Mark S., Health Policy and Management, University of California at Los Angeles, Los Angeles, California, Kuban, Deborah A., Hembroff, Larry, Regan, Meredith M., Chang, Peter, Michalski, Jeff M., Regan, Meredith, Hembroff, Larry, Wei, John T., Hamstra, Dan, and and others. Thu . "External Beam Radiation Therapy or Brachytherapy With or Without Short-course Neoadjuvant Androgen Deprivation Therapy: Results of a Multicenter, Prospective Study of Quality of Life". United States. doi:10.1016/J.IJROBP.2017.02.019.
@article{osti_22649928,
title = {External Beam Radiation Therapy or Brachytherapy With or Without Short-course Neoadjuvant Androgen Deprivation Therapy: Results of a Multicenter, Prospective Study of Quality of Life},
author = {Gay, Hiram A., E-mail: hiramgay@wustl.edu and Sanda, Martin G. and Liu, Jingxia and Wu, Ningying and Hamstra, Daniel A. and Wei, John T. and Dunn, Rodney L. and Klein, Eric A. and Sandler, Howard M. and Saigal, Christopher S. and Litwin, Mark S. and Health Policy and Management, University of California at Los Angeles, Los Angeles, California and Kuban, Deborah A. and Hembroff, Larry and Regan, Meredith M. and Chang, Peter and Michalski, Jeff M. and Regan, Meredith and Hembroff, Larry and Wei, John T. and Hamstra, Dan and and others},
abstractNote = {Purpose: The long-term effects of neoadjuvant androgen deprivation therapy (NADT) with radiation therapy on participant-reported health-related quality of life (HRQOL) have not been characterized in prospective multicenter studies. We evaluated HRQOL for 2 years among participants undergoing radiation therapy (RT) with or without NADT for newly diagnosed, early-stage prostate cancer. Methods and Materials: We analyzed longitudinal cohort data from the Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment Consortium to ascertain the HRQOL trajectory of men receiving NADT with external beam RT (EBRT) or brachytherapy. HRQOL was measured using the expanded prostate cancer index composite 26-item questionnaire at 2, 6, 12, and 24 months after the initiation of NADT. We used the χ{sup 2} or Fisher exact test to compare the shift in percentages between groups that did or did not receive NADT. Analyses were conducted at the 2-sided 5% significance level. Results: For subjects receiving EBRT, questions regarding the ability to have an erection, ability to reach an orgasm, quality of erections, frequency of erections, ability to function sexually, and lack of energy were in a significantly worse dichotomized category for the patients receiving NADT. Comparing the baseline versus 24-month outcomes, 24%, 23%, and 30% of participants receiving EBRT plus NADT shifted to the worse dichotomized category for the ability to reach an orgasm, quality of erections, and ability to function sexually compared with 14%, 13%, and 16% in the EBRT group, respectively. Conclusions: Compared with baseline, at 2 years, participants receiving NADT plus EBRT compared with EBRT alone had worse HRQOL, as measured by the ability to reach orgasm, quality of erections, and ability to function sexually. However, no difference was found in the ability to have an erection, frequency of erections, overall sexual function, hot flashes, breast tenderness/enlargement, depression, lack of energy, or change in body weight. The improved survival in intermediate- and high-risk patients receiving NADT and EBRT necessitates pretreatment counseling of the HRQOL effect of NADT and EBRT.},
doi = {10.1016/J.IJROBP.2017.02.019},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 98,
place = {United States},
year = {Thu Jun 01 00:00:00 EDT 2017},
month = {Thu Jun 01 00:00:00 EDT 2017}
}