Abstract
Background and purpose
Stereotactic body radiotherapy (SBRT) is being used for prostate cancer, but concerns
persist about toxicity compared to other radiotherapy options.
Materials and methods
We conducted a multi-institutional pooled cohort analysis of patient-reported quality
of life (QOL) [EPIC-26] before and after intensity-modulated radiotherapy (IMRT),
brachytherapy, or SBRT for localized prostate cancer. Data were analyzed by mean domain
score, minimal clinically detectable difference (MCD) in domain score, and multivariate
analyses to determine factors associated with domain scores at 2-years.
Results
Data were analyzed from 803 patients at baseline and 645 at 2-years. Mean declines
at 2-years across all patients were −1.9, −4.8, −4.9, and −13.3 points for urinary obstructive, urinary incontinence, bowel, and sexual symptom domains,
respectively, corresponding to MCD in 29%, 20%, and 28% of patients. On multivariate
analysis (vs. IMRT), brachytherapy had worse urinary irritation at 2-years (−6.8 points, p < 0.0001) but no differences in other domains (p > 0.15). QOL after SBRT was similar for urinary (p > 0.5) and sexual domains (p = 0.57), but was associated with better bowel score (+6.7 points, p < 0.0002).
Conclusions
QOL 2-years after brachytherapy, IMRT, or SBRT is very good and largely similar, with
small differences in urinary and bowel QOL that are likely minimized by modern techniques.
Keywords
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Article info
Publication history
Published online: August 11, 2015
Accepted:
July 8,
2015
Received:
May 7,
2015
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
