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Sandy Srinivas, MD
Sandy Srinivas, MD
Posted: Tuesday, August 30, 2022
With a median follow-up of 15.8 years, differences in patient-reported outcomes appeared to depend on the type of treatment patients received for prostate cancer: brachytherapy, open radical prostatectomy, and three-dimensional conformal radiation therapy (CRT). In an article published in Clinical and Translational Radiation Oncology, Zachary A. Seymour, MD, of Beaumont Health, Dearborn, Michigan, and colleagues observed temporal trends from 2 to 15 years after treatment.
“Applicability of these results to current patient cohorts is limited for each modality, as over the past 20 years, each technique has experienced considerable improvements that could affect quality of life in one or more domains,” cautioned the investigators
A total of 1,014 patients—including 902 treated with radical prostatectomy, three-dimensional CRT, or brachytherapy—and 112 prostate cancer–free control participants were examined in the quality-of-life study. The instrument used to determine quality of life, the Expanded Prostate Cancer Index (EPIC)-26, questioned participants on urinary incontinence, bowel changes, sexual difficulties, and hormonal changes, among other topics. Responses to EPIC-26 were then translated to a score on a 0 to 100 scale, with higher scores representing a better quality of life.
Analysis of the responses showed that the patient-reported quality of life for those treated with radiotherapy and prostatectomy did not indicate substantial change in disease-specific quality-of-life metrics during the middle- and long-term ranges. Patients treated with brachytherapy reported middle-term improvement in irritative quality of life and deterioration in urinary incontinence and bowel quality of life.
Overall, the changes in the quality of life of patients treated with brachytherapy, radical prostatectomy, or three-dimensional CRT were considered to be minimal. Subtle differences present in long-term, disease-specific quality of life were noted. The researchers recommended oncologists discuss these subtle differences with their patients at the time of treatment decision-making.
Disclosure: The study authors reported no conflicts of interest.
Clinical and Translational Radiation Oncology
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