A comparative study of patient-reported outcomes after contemporary radiation techniques for prostate cancer.

We aim to compare health-related quality of life (HRQoL) deterioration at 12 months in low-and intermediate-risk prostate cancer (PCa) patients treated with stereotactic ablative radiotherapy (SABR), high dose-rate brachytherapy (HDR) monotherapy and HDR boost.

Patients treated as part of 7 prospective clinical trials were included. All patients had low-or intermediate-risk PCa. Three strategies were considered: SABR, HDR monotherapy and HDR boost. HRQoL was prospectively measured at baseline and 12 months in all trials, using the Expanded Prostate Index Composite (EPIC). A minimally important difference (MID) was defined as a deterioration of HRQoL scores at 12 months compared to baseline ≥ 0.5 standard deviation of baseline score. Univariate and multivariable logistic regression using generalized estimating equations were used to compare the proportion of patients having MID between groups. A set of sensitivity analyses was conducted.

648 patients were included: 288, 173 and 187 respectively in the SABR, HDR monotherapy and HDR boost group. On univariate and multivariable analyses, SABR and HDR monotherapy compared to HDR boost, were associated with less deterioration in the urinary (38%, 40% vs. 55%; OR:0.543, 95%CI:0.320-0.922, p=0.024; OR:0.468, 95%CI:0.432-0.507, p<0.001) and sexual domains (38%, 42% vs. 47%; OR:0.762, 95%CI:0.645-0.900, p=0.001; OR: 0.786, 95%CI:0.650-0.949, p=0.012). These findings wererobust to a variety ofsensitivity analyses.

Recent monotherapeutic approaches for low- and intermediate-risk PCa are associated with the preservation of patients HRQoL. Ultimately, the questions of efficacy, toxicity, and HRQoL will be best answered by a randomized clinical trial.

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 2022 Apr 29 [Epub ahead of print]

Joelle Helou, Gerard Morton, Alex Kiss, Nicole Mittmann, Ananth Ravi, Hans Chung, Melanie Davidson, Patrick Chung, Andrea Bezjak, Andrew Loblaw

Department of Radiation Oncology, University of Toronto, Canada; Princess Margaret Cancer Centre, Canada; Institute of Health Policy, Measurement and Evaluation, University of Toronto, Canada., Department of Radiation Oncology, University of Toronto, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Canada., Institute of Health Policy, Measurement and Evaluation, University of Toronto, Canada., Department of Radiation Oncology, University of Toronto, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Canada; Institute of Health Policy, Measurement and Evaluation, University of Toronto, Canada. Electronic address: .

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