Disease‐specific symptoms and general quality of life of patients with prostate carcinoma before and after primary three‐dimensional conformal radiotherapy

Abstract

BACKGROUNDApproximately 189,000 men are diagnosed with prostate carcinoma each year and more than 1 million are living with the disease. Good prognoses and undesirable sequelae accompany each of several available primary and adjuvant treatment options. The current study explored the effects of primary three‐dimensional conformal radiotherapy with or without neoadjuvant hormonal therapy on urinary, bowel, and sexual symptoms and health‐related quality of life (HRQOL).METHODSA prospective, repeated‐measures design study included 100 patients. Data from the Medical Outcomes Study Short Form Health Survey (a measure of general HRQOL) and a 12‐item symptom questionnaire were collected before the start of radiotherapy, approximately 1–3 months after completion of treatment, and again approximately 5–10 months after completion of treatment for follow‐up.RESULTSPatients reported few urinary symptoms after treatment. Bowel frequency and urgency were reported more frequently posttreatment and at follow‐up. Erectile difficulties, which were common pretreatment, were reported with increased frequency posttreatment and at follow‐up. General HRQOL scores were higher than age‐related general population norms for men at all three data collection times, but there were significant losses posttreatment for patients' physical functioning and vitality. At the 5–10‐month follow‐up, physical functioning remained lower but vitality scores regained some of the losses. A more extended follow‐up is needed. Neoadjuvant therapy, which was received before the pretreatment data collection, had a deleterious effect on erectile functioning but no interactive effects with the radiotherapy on symptoms or HRQOL.CONCLUSIONSAlthough patients with a diagnosis of prostate carcinoma experienced increased bowel and sexual dysfunction and decreased vitality after radiotherapy, their HRQOL scores remained at or above age‐related general population norms. Cancer 2003. © 2003 American Cancer Society.

Longitudinal Analysis of Quality of Life in Patients Receiving Conformal Radiation Therapy for Prostate Cancer

“…Longitudinal studies on QoL in patients with CRT for prostate cancer are rare [2,14,16,18,19,27,30], and mostly have a follow-up of ≤ 1 year [2,14,16,18,27,30]. In concordance with our results, these studies demonstrate that QoL is not profoundly impaired by CRT and that there is only a temporary deterioration of a limited number of QoL domains during or shortly after therapy [14,18,27] [14].…”

“…In concordance with our results, these studies demonstrate that QoL is not profoundly impaired by CRT and that there is only a temporary deterioration of a limited number of QoL domains during or shortly after therapy [14,18,27] [14]. They observed a temporary decline of role functioning and a temporary increase of fatigue during CRT.…”

“…30 weeks after CRT, no significant difference from the baseline values was observed for any of the QoL domains. Staff et al presented QoL data (SF-36) on 60 patients with prostate cancer before, during, and up to 10 months after CRT [27]. They found a decline in physical composite scores, physical functioning, the role physical score, and the vitality score.…”

Phenotypic and molecular characteristics associated with various domains of quality of life in oncology patients and their family caregivers

“…In some prospective studies, the physical [4–9] and social [7,9–11] domains of patients’ QOL deteriorated during RT. In four other studies [6,12–14], the psychological domain of QOL improved during RT.…”

Quality-of-Life Outcomes in Oncology

“…The cause is poorly understood, but its relation to reduction in QOL has been reported in prostate [11,12], breast [13,14], rectal [15], and uterine [16] cancers. The addition of chemotherapy to RT further increases fatigue.…”