A comparative study of quality of life in patients with localized prostate cancer treated at a single institution: Stereotactic ablative radiotherapy or external beam + high dose rate brachytherapy boost |
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| Affiliation: | 1. Odette Cancer Centre, Sunnybrook Health Sciences Centre, Canada;2. Department of Radiation Oncology, University of Toronto, Canada;3. Institute for Health, Policy, Measurement and Evaluation, University of Toronto, Canada;1. Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina;2. Surgery Section, Durham Veterans Administration, and Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California;1. Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada;2. Department of Radiation Oncology, University of California, Los Angeles, California, USA;3. St. Francis Hospital, Roslyn, New York, USA;4. 21st Century Oncology, Fort Myers, Florida, USA;5. Department of Radiation Oncology, Georgetown University, Washington, DC, USA;7. Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada;11. Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada;1. Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada;2. Institute for Health Policy, Measurement and Evaluation, University of Toronto, Toronto, Canada;3. Clinical Trials, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada;1. Odette Cancer Centre, Sunnybrook Health Sciences Centre, Canada;2. Department of Radiation Oncology, University of Toronto, Canada;3. Department of Radiation Oncology, CancerCare Manitoba, Canada;4. Institute of Health Policy, Measurement and Evaluation, University of Toronto, Canada |
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| Abstract: | PurposeTo 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 materialsPatient self-reported QOL was prospectively measured among patients from two sequential phase 2 clinical trials: 1-SABR 35 Gy/5 fractions/5 weeks, 2–15 Gy HDR 1 fraction, followed by EBRT 37.5 Gy/15 fractions/3 weeks. The expanded prostate cancer index composite was assessed at baseline and q6 monthly up to 5 years. 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).Results84 and 123 patients were treated on the SABR and HDR boost studies, with a median follow up of 51 and 61 months 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).ConclusionPatients treated with HDR-boost reported deterioration of QOL particularly in sexual domains in comparison with SABR. |
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| Keywords: | Prostate cancer Quality of life Stereotactic ablative body radiotherapy High dose rate brachytherapy |
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