Health-Related Quality of Life 2 Years After Treatment With Radical Prostatectomy, Prostate Brachytherapy, or External Beam Radiotherapy in Patients With Clinically Localized Prostate Cancer
- Unidad de Investigacion en Servicios Sanitarios, IMIM-Hospital del Mar, Barcelona (Spain)
- Servicio de Urologia, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat (Spain)
- Servicio de Oncologia Radioterapica, Institut Catala d'Oncologia, L'Hospitalet de Llobregat (Spain)
- Servicio de Oncologia Radioterapica, Instituto Oncologico de Guipuzcoa, San Sebastian (Spain)
- Servicio de Oncologia Radioterapica, Capio Hospital General de Catalunya, Sant Cugat del Valles (Spain)
- Servicio de Oncologia Radioterapica, Centro Oncologico de Galicia, A Coruna (Spain)
- Servicio de Oncologia Radioterapica, Hospital Ramon y Cajal, Madrid (Spain)
- Servicio de Oncologia Radioterapica, Hospital Regional Carlos Haya, Malaga (Spain)
- Servicio de Oncologia Radioterapica, Hospital Virgen del Rocio, Sevilla (Spain)
- Servicio de Urologia, Fundacion Puigvert, Barcelona (Spain)
- Servicio de Oncologia Radioterapica, Hospital de la Santa Creu i Sant Pau, Barcelona (Spain)
Purpose: To compare treatment impact on health-related quality of life (HRQL) in patients with localized prostate cancer, from before treatment to 2 years after the intervention. Methods and Materials: This was a longitudinal, prospective study of 614 patients with localized prostate cancer treated with radical prostatectomy (134), three-dimensional external conformal radiotherapy (205), and brachytherapy (275). The HRQL questionnaires administered before and after treatment (months 1, 3, 6, 12, and 24) were the Medical Outcomes Study 36-Item Short Form, the Functional Assessment of Cancer Therapy (General and Prostate Specific), the Expanded Prostate Cancer Index Composite (EPIC), and the American Urological Association Symptom Index. Differences between groups were tested by analysis of variance and within-group changes by univariate repeated-measures analysis of variance. Generalized estimating equations (GEE) models were constructed to assess between-group differences in HRQL at 2 years of follow-up after adjusting for clinical variables. Results: In each treatment group, HRQL initially deteriorated after treatment with subsequent partial recovery. However, some dimension scores were still significantly lower after 2 years of treatment. The GEE models showed that, compared with the brachytherapy group, radical prostatectomy patients had worse EPIC sexual summary and urinary incontinence scores (-20.4 and -14.1; p < 0.001), and external radiotherapy patients had worse EPIC bowel, sexual, and hormonal summary scores (-3.55, -5.24, and -1.94; p < 0.05). Prostatectomy patients had significantly better EPIC urinary irritation scores than brachytherapy patients (+4.16; p < 0.001). Conclusions: Relevant differences between treatment groups persisted after 2 years of follow-up. Radical prostatectomy had a considerable negative effect on sexual functioning and urinary continence. Three-dimensional conformal radiotherapy had a moderate negative impact on bowel functioning, and brachytherapy caused moderate urinary irritation. These results provide relevant information for clinical decision making.
- OSTI ID:
- 21124468
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 72, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2007.12.024; PII: S0360-3016(07)04764-5; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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