Longitudinal assessment of quality of life after surgery, conformal brachytherapy, and intensity-modulated radiation therapy for prostate cancer

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
Michael J ZelefskyPeter T Scardino

Abstract

We evaluated quality-of-life changes (QoL) in 907 patients treated with either radical prostatectomy (open or laparoscopic), real-time planned conformal brachytherapy, or high-dose intensity-modulated radiotherapy (IMRT) on a prospective IRB-approved longitudinal study. Validated questionnaires given pretreatment (baseline) and at 3, 6, 9, 12, 15, 18, 24, 36, and 48 months addressed urinary function, urinary bother, bowel function, bowel bother, sexual function, and sexual bother. At 48 months, surgery had significantly higher urinary incontinence than others (both P<.001), but fewer urinary irritation/obstruction symptoms (all P<.001). Very low levels of bowel dysfunction were observed and only small subsets in each group showed rectal bleeding. Brachytherapy and IMRT showed better sexual function than surgery accounting for baseline function and other factors (delta 14.29 of 100, 95% CI, 8.57-20.01; and delta 10.5, 95% CI, 3.78-17.88). Sexual bother was similar. Four-year outcomes showed persistent urinary incontinence for surgery with more obstructive urinary symptoms for radiotherapy. Using modern radiotherapy delivery, bowel function deterioration is less-often observed. Sexual function was strongly affected in all groups ...Continue Reading

References

Apr 1, 2005·International Journal of Cancer. Journal International Du Cancer·Ida J KorfageHarry J de Koning
Apr 20, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·David C MillerJohn T Wei
Feb 18, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Michael J ZelefskyPeter T Scardino
Mar 10, 2010·Archives of Internal Medicine·Thomas L JangDeborah Schrag
Oct 6, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Yolanda PardoMontserrat Ferrer
Aug 13, 2013·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Wouter SchaakeAlfons C M van den Bergh

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Citations

Jun 22, 2017·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Marcel J SteggerdaLuc M F Moonen
Jun 8, 2018·American Journal of Men's Health·Rachel TheraDr Kunal Jana
May 11, 2017·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·Isabelle KindtsAntoon Lambrecht
May 28, 2019·International Journal of Urology : Official Journal of the Japanese Urological Association·Katsumasa NakamuraRyo Ishiba
Jun 15, 2021·Frontiers in Surgery·Claudia KeschGiorgio Gandaglia

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