Longitudinal assessment of quality of life after surgery, conformal brachytherapy, and intensity-modulated radiation therapy for prostate cancer Journal Article


Authors: Zelefsky, M. J.; Poon, B. Y.; Eastham, J.; Vickers, A.; Pei, X.; Scardino, P. T.
Article Title: Longitudinal assessment of quality of life after surgery, conformal brachytherapy, and intensity-modulated radiation therapy for prostate cancer
Abstract: Purpose We evaluated quality-of-life changes (QoL) in 907 patients treated with either radical prostatectomy (open or laparoscopic), real-time planned conformal brachytherapy, or high-dose intensity-modulated radiotherapy (IMRT) on a prospective IRB-approved longitudinal study. Methods Validated questionnaires given pretreatment (baseline) and at 3, 6, 9, 12, 15, 18, 24, 36, and 48 months addressed urinary function, urinary bother, bowel function, bowel bother, sexual function, and sexual bother. Results At 48 months, surgery had significantly higher urinary incontinence than others (both P <.001), but fewer urinary irritation/obstruction symptoms (all P <.001). Very low levels of bowel dysfunction were observed and only small subsets in each group showed rectal bleeding. Brachytherapy and IMRT showed better sexual function than surgery accounting for baseline function and other factors (delta 14.29 of 100, 95% CI, 8.57-20.01; and delta 10.5, 95% CI, 3.78-17.88). Sexual bother was similar. Four-year outcomes showed persistent urinary incontinence for surgery with more obstructive urinary symptoms for radiotherapy. Using modern radiotherapy delivery, bowel function deterioration is less-often observed. Sexual function was strongly affected in all groups yet significantly less for radiotherapy. Conclusions Treatment selection should include patient preferences and balance predicted disease-free survival over a projected time vs potential impairment of QoL important for the patient. © 2015 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 118 (2016) 8591.
Keywords: quality of life; radiotherapy; prostate cancer; brachytherapy; surgery
Journal Title: Radiotherapy and Oncology
Volume: 118
Issue: 1
ISSN: 0167-8140
Publisher: Elsevier Inc.  
Date Published: 2016-01-01
Start Page: 85
End Page: 91
Language: English
DOI: 10.1016/j.radonc.2015.11.035
PROVIDER: scopus
PUBMED: 26780999
PMCID: PMC4848377
DOI/URL:
Notes: Article -- Export Date: 4 April 2016 -- Source: Scopus
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MSK Authors
  1. Michael J Zelefsky
    656 Zelefsky
  2. Peter T Scardino
    630 Scardino
  3. Andrew J Vickers
    593 Vickers
  4. James Eastham
    444 Eastham
  5. Xin Pei
    104 Pei
  6. Jessica Bing Ying Poon
    15 Poon