PURPOSE: To compare the quality of life (QOL) in patients treated with stereotactic ablative radiation therapy (SABR) alone or high dose rate (HDR) brachytherapy+hypofractionated external beam radiotherapy (EBRT).
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METHODS AND MATERIALS: Patient self-reported QOL was prospectively measured among patients from two sequential phase 2 clinical trials: 1-SABR 35Gy/5fractions/5weeks, 2-15Gy HDR 1 fraction, followed by EBRT 37.5Gy/15fractions/3weeks. The expanded prostate cancer index composite was assessed at baseline and q6 monthly up to 5years. Urinary, bowel and sexual domains were analyzed. A minimally clinical important change (MCIC) was defined as 0.5*standard deviation of the baseline for each domain. Fisher exact test and general linear mixed model were used (p< 0.05).
RESULTS: 84 and 123 patients were treated on the SABR and HDR boost studies, with a median follow up of 51 and 61months respectively. There was a significant difference in MCIC between treatments in the urinary function and bother (p< 0.0001), the bowel function (p=0.0216) and the sexual function (p=0.0419) and bother (p=0.0290) domains in favor of the SABR group. Of patients who reported no problem with their sexual function at baseline, 7% and 23% respectively considered it to be a moderate to big problem on follow up (p=0.0077).
CONCLUSION: Patients treated with HDR-boost reported deterioration of QOL particularly in sexual domains in comparison with SABR.
Helou J, Morton G, Zhang L, Deabreu A, D'Alimonte L, Elias E, Musunuru HB, Mamedov A, Ravi A, Chung H, Cheung P, Loblaw A Are you the author?
Odette Cancer Centre, Sunnybrook Health Sciences Centre, Canada; Department of Radiation Oncology, University of Toronto, Canada; Institute for Health, Policy, Measurement and Evaluation, University of Toronto, Canada.
Reference: Radiother Oncol. 2014 Dec;113(3):404-9.