Quality-of-life questionnaire results 2 and 3 years after radiotherapy for prostate cancer in a randomized dose-escalation study.
OBJECTIVE
To assess patient-reported prostate cancer-specific quality of life 2 and 3 years after radiotherapy to the prostate in a randomized dose-escalation trial of 70 versus 78 Gy conducted from 1993 to 1998.


METHODS
Two years after completing radiotherapy, a questionnaire that assessed bladder, rectal, and sexual function was sent to 301 patients in the study. Three years after treatment, a second questionnaire was sent to the 175 patients with adequate follow-up.


RESULTS
Three years after radiotherapy, urinary incontinence was reported by 35% of patients, but only 6% required the use of a pad or other protective device. Patients reported increased leakage with a full bladder (urge incontinence) between the 2 and 3-year questionnaires (42% versus 50%; P = 0.03). At 3 years, 33% of patients reported rectal bleeding compared with 47% at 2 years (P = 0.006). Patients in the 78-Gy arm reported more frequent bowel movements at 3 years and less change in bowel function at 2 years than patients in the 70-Gy arm. Before radiotherapy, 84% of patients reported erections adequate for intercourse at least a few times during the previous year. After 2 and 3 years, this had decreased to 49% and 41%, respectively (P <0.02).


CONCLUSIONS
By patient-reported questionnaire, 78 Gy produced an increase in bowel movement frequency and no increase in bladder or sexual side effects at 3 years compared with 70 Gy. Comparing the results 2 and 3 years after radiotherapy, the symptoms of rectal bleeding had improved, erectile function had decreased, and urinary urge incontinence had increased.
Little
Darren J
DJ
Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Kuban
Deborah A
DA
Levy
Lawrence B
LB
Zagars
Gunar K
GK
Pollack
Alan
A
D000230:Adenocarcinoma / Q000523:psychology / Q000532:radiotherapy*; D000368:Aged; D003967:Diarrhea / Q000209:etiology / Q000523:psychology; D004307:Dose-Response Relationship, Radiation; D007172:Erectile Dysfunction / Q000209:etiology / Q000523:psychology; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000523:psychology; D006417:Hematuria / Q000209:etiology / Q000523:psychology; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011471:Prostatic Neoplasms / Q000523:psychology / Q000532:radiotherapy*; D011788:Quality of Life; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy / Q000009:adverse effects / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology / Q000523:psychology