Quality of life after palliative radiotherapy in patients with hormone-resistant prostate cancer: single institution experience.
OBJECTIVE
To review the development, methodology and difficulties of evaluating the quality of life (QoL) in patients with hormone-resistant prostate cancer, and to analyse the subjective effect of palliative radiotherapy among these patients.


METHODS
Since 1986, a self-administered QoL questionnaire has been developed for patients with hormone-resistant prostate cancer. The study group included 137 such patients, with a median age of 70 years (range 48-87), who received either 89Sr (31) or external beam radiotherapy (106) because of painful bone metastases. Quality of life was assessed in all patients before treatment and, if possible, 3 months afterwards.


RESULTS
The questionnaire had acceptable psychometric properties (validity, reliability). In these patients with very advanced disease, palliative radiotherapy proved less effective than reports in the literature might suggest.


CONCLUSIONS
In patients with hormone-resistant prostate cancer, quality of life assessment is both possible and desirable for the evaluation of palliative treatment. The patients' perception of physical function represents an independent prognostic factor of overall survival together with alkaline phosphatase and performance status. Valid and reliable QoL questionnaires are now available, though further research is required to establish the most effective way of using them. At 3 months palliative radiotherapy was effective in only 25% of the patients investigated, two-thirds of whom had > or = 20 hot spots on bone scan. Palliative radiotherapy should probably be offered during an earlier phase of the disease.
Fosså
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SD
Department of Medical Oncology and Radiotherapy, Norwegian Radium Hospital, Oslo.
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods* / Q000401:mortality / Q000523:psychology; D011471:Prostatic Neoplasms / Q000401:mortality / Q000523:psychology / Q000532:radiotherapy*; D011594:Psychometrics; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D016896:Treatment Outcome