Four-year quality-of-life outcomes in low- to intermediate-risk prostate cancer patients following definitive stereotactic body radiotherapy versus management with active surveillance.

To review quality-of-life (QoL) metrics between patients who underwent definitive stereotactic body radiotherapy (SBRT) versus active surveillance (AS) for management of low- to intermediate-risk prostate cancer (PCa).

A prospectively maintained PCa database was reviewed containing results of patient-reported QoL surveys. Patients with localized disease who chose AS or SBRT and completed at least one survey within four years of treatment were included. Patients who received salvage therapy were excluded. Survey results were compared across time using mixed-effects repeated measures analysis of covariance models that adjusted for factors significant in univariate analysis. A group x time interaction effect was examined to compare rate of change over time between AS and SBRT. P < 0.05 was significant.

148 AS and 161 SBRT patients were included. Significantly more SBRT patients had intermediate-risk disease (p < 0.0001). AS had significantly worse sexual function compared to SBRT across time. While not significant, bowel function scores were lower for SBRT patients across time points. SBRT patients had significantly lower anxiety than AS patients at 24 months (p < 0.011) and 36 months (p < 0.010). Urinary function though worse in SBRT patients at 12 months in EPIC, was not significantly different in both groups across time points.

SBRT patients have excellent QoL compared to AS with regard to anxiety post treatment. Though SBRT patients initially have worse urinary and bowel function than AS, scores were eventually similar in both cohorts by 48 months. SBRT patients have significantly worse sexual function post treatment. This study may help facilitate counseling in patients choosing PCa treatment.

World journal of urology. 2022 Jul 12 [Epub ahead of print]

Ashley Monaco, Jessica Sommer, Meredith Akerman, Jonathan W Lischalk, Jonathan Haas, Anthony Corcoran, Aaron Katz

New York Institute of Technology College of Osteopathic Medicine, 101 Northern Boulevard, Old Westbury, NY, 11568, USA. ., Department of Urology, New York University Langone, Hospital - Long Island, 1300 Franklin Ave, Mineola, NY, 11530, USA., Biostatistics Core, Division of Health Services Research, New York University Langone, Hospital - Long Island, 259 1st St., Mineola, NY, 11501, USA., Department of Radiation Oncology, New York University Langone, Hospital - Long Island, 259 1st St., Mineola, NY, 11501, USA.

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