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).
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.
Written by:
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.
doi: 10.1016/j.radonc.2014.10.013
PubMed Abstract
PMID: 25466371