Symptoms predicting health-related quality of life in prostate cancer patients treated with localized radiation therapy

Abstract

ObjectivePatient-reported health-related quality-of-life (HRQOL) measures can provide guidance for treatment decision making, symptom management, and discharge planning. HRQOL is often influenced by the distress experienced by patients from disease or treatment-related symptoms. This study aimed to identify symptoms that can predict changes in HRQOL in men undergoing external beam radiation therapy (EBRT) for nonmetastatic prostate cancer (NMPC).MethodsFifty-one men with NMPC scheduled for EBRT were assessed at the baseline, at the midpoint of EBRT, and at the end of EBRT. All participants received 38–42 daily doses of EBRT (five times a week), depending on the stage of their disease. Validated questionnaires were administered to evaluate depressive symptoms, urinary and sexual functions, bowel issues, symptom-related distress, fatigue, and HRQOL. Pearson correlations, repeated-measures ANOVA, and multiple regressions examined the relationships among variables.ResultsIntensification of symptoms and increased symptom-related distress, with a corresponding decline in HRQOL, were observed during EBRT in men with NMPC. Changes in symptoms and symptom distress were associated with changes in HRQOL at the midpoint of EBRT (r=−0.37 to −0.6, P=0.05) and at the end of EBRT (r=−0.3 to −0.47, P=0.01) compared with the baseline. The regression model comprising age, body mass index, Gleason score, T category, androgen-deprivation therapy use, radiation dose received, symptoms (urinary/sexual/bowel problems, fatigue), and overall symptom distress explained 70% of the variance in predicting HRQOL. Urinary problems and fatigue significantly predicted the decline in HRQOL during EBRT.ConclusionIdentifying specific symptoms that can influence HRQOL during EBRT for NMPC can provide feasible interventional targets to improve treatment outcomes.

Data-driven translational prostate cancer research: from biomarker discovery to clinical decision

“…Clinical symptoms especially the lower urinary tract symptoms provide valuable guidance for PCa diagnosis, though the specificity still needs to be investigated. Several studies focused on the urinary problems associated with the recurrence and life quality of PCa patients after radiotherapy [64][65][66]. Meanwhile sexual dysfunction and depression caused by different therapeutic regimes would be important for patient prognosis tracking [67,68].…”

The effect of nutritional interventions involving dietary counselling on gastrointestinal toxicities in adults receiving pelvic radiotherapy – A systematic review

“…Additionally, radiotherapy-induced morbidity, which results from treatment toxicities, may compromise a patient's nutritional status and negatively impact their quality of life (QOL), both during and after treatment. [1][2][3] Toxicity to the GI tract is usually a result of an inflammatory response due to repetitive radiation injury to the small and large intestines, exacerbated by the gut's rapid cell turnover rate. 4 The inflammatory response leads to increased susceptibility of the bowels to radiation damage, which can reduce the absorptive surface area available and lower enzyme activity.…”

“…Additionally, radiotherapy‐induced morbidity, which results from treatment toxicities, may compromise a patient’s nutritional status and negatively impact their quality of life (QOL), both during and after treatment. 1 , 2 , 3 …”