Previously patient reported quality of life (QOL) was reported in men with prostate cancer a mean 2 and 6 years post treatment with open radical prostatectomy (RP), 3D conformal radiation therapy (3D CRT), or 125I low dose rate (LDR) brachytherapy (BT). Herein we update the results 15 years post-treatment QOL.
The Expanded Prostate Cancer Index (EPIC) domains were scored with differences evaluated at a median 15.8 years follow up based upon mean EPIC summary domains by ANOVA with pairwise post-hoc comparisons adjusted for age. Patient differences of current survey from first cross-section are reported as median change in summary score for each treatment group at median of 2.2 and 6.0, and 15.8 years.
Among men still alive response rate was 52% in BT, 60% in 3D CRT, and 62% in RP resulting in 30, 41, and 330 QOL questionnaires to evaluate for each corresponding modality at median follow up of 15.8 years. Men were a mean 75.3, 83.6, and 79.3 years of age after RP, 3DCRT, and BT, respectively.At a median of 15.8 years, there were largely persistent differences in EPIC domains without substantial evolution in QoL from middle time points. Persistent worsening in urinary irritative and bowel domain with 3DRT or BT compared to RP. Trend towards worse urinary incontinence with RP were noted without statistical differences within radiotherapy options.
As the EPIC patient reported outcomes with the longest follow-up, these data uniquely reveal temporal trends from 2 to 15 years post treatment. However, the treatment modalities of open RP, 3D CRT without image guidance or intensity modulation, and BT without peripheral loading or MRI guidance may not reflect modern techniques.
Clinical and translational radiation oncology. 2022 Jun 01*** epublish ***
Zachary A Seymour, Stephanie Daignault-Newton, P W McLaughlin, Howard Sandler, William Jackson, Skyler B Johnson, David Miller, John Wei, Martin Sanda, Daniel A Hamstra
Beaumont Health, Department of Radiation Oncology, Dearborn, MI, United States., University of Michigan, Department of Radiation Oncology, Ann Arbor MI, United States., Cedars Sinai Medical Center, Department of Radiation Oncology, Los Angeles, CA, United States., The University of Utah, Department of Radiation Oncology, Salt Lake City, UT, United States., University of Michigan, Department of Urology, Ann Arbor, MI, United States., Emory University, Department of Urology, Atlanta, GA, United States., Baylor College of Medicine, Department of Radiation Oncology, Houston, TX, United States.