SAN FRANCISCO, CA USA (UroToday.com) - Background: To evaluate long-term quality of life (QOL) in 630 patients with high-risk prostate cancer (HRPC) treated in a prospective randomized phase III trial (PCS IV clinical trials, Gov. # NCT 00223171).
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Methods: Patients were randomized to radiotherapy (RT) plus 36 or 18 months of androgen deprivation therapy (ADT). QOL was assessed by two validated tools: EORTC30 (30 items) and PR25 (25 items). The 55 items were regrouped into 21 scales: 15 for EORTC30 and six for PR25. All items and scales scores were linearly transformed to a 0 to 100 points scale. A p value less than 0.01 was considered statistically significant and a difference between groups in mean scores of greater than or equal to 10 points as clinically relevant. Patient-reported outcomes were filled out before treatments, every six months during ADT, four months after and then once a year for five years. All items and scales scores were analysed with general linear model with repeated measures to evaluate changes between groups and over time periods.
Results: Three hundred ten patients were randomized to 36 months and 320 to 18 months of ADT, with a median follow-up of 79 months, there was no difference in survival outcomes. The global adherence to QOL questionnaires was 72.4% (10,052 out of 13,880). When comparing the two groups, 6 out of 21 scales (physical, emotional, and social functioning, fatigue, hormonal treatment-related symptoms, and sexual active) and 14 out of 55 items (trouble with long walks, stay in bed during the day, weakness, tenseness, worry, irritable, depressed, close to a toilet, blood in stools, hot flushes, enlarged breasts, interested in sex, sexually active, enjoyable sex) were statistically significant (p < 0.01) in favor of the 18 months ADT group. None of the 21 scales reached clinical relevance (mean scores greater than or equal to 10 points) sexual active being the highest score with 9.0 points of difference. For the 14 statistically significant items, interest in sex with 9.9 points and sexually active with 8.1 points were close to clinical relevance and hot flushes with 24 points and enjoyable sex with 18 points had important clinical relevance at 42 months.
Conclusions: In HRPC treated with RT and ADT, reducing the duration of ADT from 36 to 18 months improves QOL, without a negative impact on survival.
Source of Funding: AstraZeneca Pharmaceuticals grant.
Authored by Abdenour Nabid, Nathalie Carrier, André-Guy Martin, Jean-Paul Bahary, Luis Souhami, Marie Duclos, François Vincent, Sylvie Vass, Boris Bahoric, Robert Archambault, and Céline Lemaire for presentation at the 2014 Genitourinary Cancers Symposium - January 30 - February 1, 2014 - San Francisco Marriott Marquis - San Francisco, California USA
Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC; Centre Hospitalier Universitaire de Québec, Québec City, QC; Centre Hospitalier Universitaire de Montréal, Montréal, QC; Centre Universitaire de Santé McGill, Montréal, QC; Centre Hospitalier Régional de Trois-Rivières, Trois-Rivières, QC; Centre de Santé et Services Sociaux de Chicoutimi, Chicoutimi, QC; Hôpital Général Juif de Montréal, Montréal, QC; Hôpital de Gatineau, Gatineau, QC; Hôpital Maisonneuve-Rosemont de Montréal, Montréal, QC