Prostate Cancer Coverage from Every Angle

Comparison of Radiation Therapies for Prostate Cancer Based on Quality of Life

By: Lauren Harrison, MS
Posted: Friday, October 25, 2019

Patient-reported quality of life seems to be improved when high-dose–rate (HDR) brachytherapy or stereotactic body radiation therapy is used to treat prostate cancer when compared with low-dose–rate (LDR) brachytherapy, according to a large prospective cohort. Jonathan J. Paly, DO, of Fox Chase Cancer Center, Philadelphia, presented his team’s results at the 2019 Annual Meeting of the American Society for Radiation Oncology (ASTRO; Abstract 2687) and published them in the International Journal of Radiation Oncology • Biology • Physics.

“When patients are looking at the different options for treating prostate cancer, these findings may help guide them toward high-dose brachytherapy or stereotactic body radiation therapy,” Dr. Paly said in a Fox Chase press release. “If they are eligible for both, it suggests the need for a longer informed discussion with their physician about the possible differences between the two.”

Patients recruited to the study had received LDR or HDR brachytherapy or stereotactic body radiation therapy from 2001 to 2017. All patients completed International Prostate Symptom Score (IPSS) and Sexual Health Inventory for Men (SHIM) surveys; patients receiving HDR brachytherapy or stereotactic body radiation therapy additionally completed the Expanded Prostate Cancer Index Composite Short Form (EPIC-26).

A total of 338 patients received LDR brachytherapy, 101 received HDR brachytherapy, and 71 were treated with stereotactic body radiation therapy. The baseline IPSS scores were similar among all three modalities; however, LDR and HDR scores worsened at early (+1.9 and +7.3) and late (+1.3 and +3.5) time points compared with baseline. After adjustment, HDR brachytherapy and stereotactic body radiation therapy were found to show significant early (–5.4 and –7.0) and late (–2.1 and –3.5) improvements on IPSS scoring compared with LDR brachytherapy. In addition, the three modalities had similar baseline SHIM scores, and all declined at early and late follow-up. Finally, late EPIC urinary irritative scores were worse after HDR brachytherapy compared with both baseline and stereotactic body radiation therapy.

Disclosure: The study authors reported no conflicts of interest.

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