Health-Related Quality of Life in Patients With Locally Advanced Prostate Cancer After 76 Gy Intensity-Modulated Radiotherapy vs. 70 Gy Conformal Radiotherapy in a Prospective and Longitudinal Study

Abstract

Purpose: To compare quality of life (QoL) after 70 Gy conformal radiotherapy with QoL after 76 Gy intensitymodulated radiotherapy (IMRT) in patients with locally advanced prostate carcinoma. Methods and Materials: Seventy-eight patients with locally advanced prostate cancer were treated with 70 Gy three-field conformal radiotherapy, and 92 patients received 76 Gy IMRT with fiducial markers for position verification. Quality of life was measured by RAND-36, the European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30(+3)), and the prostate-specific EORTC QLQ-PR25, before radiotherapy (baseline) and 1 month and 6 months after treatment. Quality of life changes in time (baseline vs. 1 month and baseline vs. 6 months) of $10 points were considered clinically relevant. Results: Differences between the treatment groups for QoL changes over time occurred in several QoL domains. The 76-Gy group revealed no significant deterioration in QoL compared with the 70-Gy group. The IMRT 76-Gy group even demonstrated a significantly better change in QoL from baseline to 1 month in several domains. The conformal 70-Gy group revealed temporary deterioration in pain, role functioning, and urinary symptoms; for the IMRT 76-Gy group a better QoL in terms of change in health existed after 1 month, which persisted after 6 months. For both treatment groups temporary deterioration in physical role restriction occurred after 1 month, and an improvement in emotional role restriction occurred after 6 months. Sexual activity was reduced after treatment for both groups and remained decreased after 6 months. Conclusions: Intensity-modulated radiotherapy and accurate position verification seem to provide a possibility to increase the radiation dose for prostate cancer without deterioration in QoL. Ó 2007 Elsevier Inc.

Quality-of-Life Outcomes in High-Risk Prostate Cancer Patients Treated with Helical Tomotherapy in a Hypofractionated Radiation Schedule with Long-Term Androgen Suppression

“…Published comparisons of conventional and hypofractionated radiation schedules for the treatment of prostate cancer indicate that recurrence-free survival is equal or improved with hypofractionation [21][22][23] . Those studies also showed that the qol of prostate cancer patients is either similar or better with the hypofractionated schedules [24][25][26][27][28][29][30] .…”

“…The 1-and 6-month follow-up was based on the scoring system described ( Table i). The qol scores for each of the 18 items for each follow-up point (1,6,12,18,24,30, and 36 months) were compared with the baseline scores using the generalized estimating equation approach 33 . That approach accounts for the within-subject correlations arising because of repeated measurements of the same individual.…”

“…Of the 60 patients, 58 received ast. The University of California-Los Angeles Prostate Cancer Index questionnaire was used to prospectively measure qol at baseline (month 0) and at 1,6,12,18,24,30, and 36 months after radiation treatment. The generalized estimating equation approach was used to compare the qol scores at 1,6,12,18,24,30, and 36 months with those at baseline.…”

“…Patients completed qol questionnaires before commencing radiation treatment (baseline) and at 1,6,12,18,24,30, and 36 months after completion of radiation treatment. The questionnaires were selfadministered by the patients on their own time with no assistance from clinical staff.…”

Acute toxicity in prostate carcinoma patients treated with kV-CBCT guided IMRT/VMAT

“…IMRT ile de geçici yan etkilerin görülebileceği çeşitli çalışmalarla bildirilmiştir. [18,19] Yoğunluk ayarlı radyoterapi sonrası grad 2 ve üzeri üriner yan etki yaklaşık %30-40 oranında gö-rülmektedir [18,20] . Gİ yan etkiler ise De Meerleer ve ark.…”