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1/2021
vol. 13
abstract:
Original paper
Five-year quality of life in patients with high-risk localized prostate cancer treated with external beam radiotherapy alone versus external beam radiotherapy with high-dose-rate brachytherapy boost: a prospective multicenter study
Montserrat Ferrer
2, 3, 5
,
1.
Servicio de Oncología Radioterápica, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain
2.
Unidad de Investigación en Servicios Sanitarios, IMIM-Hospital del Mar, Barcelona, Spain
3.
CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
4.
Pompeu Fabra University (UPF), Barcelona, Spain
5.
Universitat Autónoma de Barcelona, Bellaterra, Spain
6.
Servicio de Oncología Radioterápica, Instituto Oncológico de Guipuzkoa, San Sebastián, Spain
7.
Fundación IMOR, Institut Mèdic Onco-Radioterapia, Barcelona, Spain
8.
Servicio de Oncología Radioterápica, Hospital Universitario Central de Asturias, Oviedo, Spain
9.
Servicio de Oncología Radioterápica, Hospital do Meixoeiro, Vigo, Spain
10.
Servicio de Oncología Radioterápica, Hospital Universitari i Politècnic La Fe, Valencia, Spain, and Hospital Universitari General de Catalunya Quiron Salut, Sant Cugat del Vallés, Barcelona, Spain
J Contemp Brachytherapy 2021; 13, 1: 1–11
Online publish date: 2021/02/18
Introduction
Brachytherapy (BT) and external beam radiation therapy (EBRT) are effective treatments for high-risk prostate cancer (PCa). However, the impact of these treatments on health-related quality of life (HRQL) remains unclear. In this study, we compared EBRT alone with EBRT plus a boost with high-dose rate (HDR)-BT to determine the impact on HRQL in patients with high-risk PCa.
Material and methods
Prospective, multicenter study comparing patients with high-risk PCa treated with EBRT alone or EBRT + HDR-BT from 2004 to 2006. HRQL was assessed at baseline (pre-treatment) and periodically over the 5-year follow-up, using the SF-36 (v.2), EPIC, and FACT-G and FACT-P questionnaires.
Results
A total of 129 patients were included in the study, of these, 41 received EBRT alone and 88 EBRT + HDR-BT. All patients received hormonotherapy. Baseline clinical characteristics were similar, except for a slightly higher mean number of comorbidities in the EBRT group. During follow-up, the only significant between-group difference was a greater worsening on EPIC hormonal domain in the EBRT alone group (p = 0.028). There were no significant differences in time and interaction of treatment in SF-36, and FACT-G and FACT-P questionnaires or EPIC urinary incontinence, urinary irritative-obstructive, and bowel and sexual domains over the 5-year follow-up. Oncological outcomes were similar in both groups.
Conclusions
After five years of follow-up, EBRT alone or combined with HDR-BT boost had a similar impact on HRQL in patients with high-risk localized PCa. However, patients in the EBRT alone group experienced greater worsening of hormonal domain according to EPIC questionnaire.
keywords:
quality of life, prostate cancer, external beam radiotherapy, high-dose-rate brachytherapy
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