Disease-specific symptoms and general quality of life of patients with prostate carcinoma before and after primary three-dimensional conformal radiotherapy.
BACKGROUND
Approximately 189,000 men are diagnosed with prostate carcinoma each year and more than 1 million are living with the disease. Good prognoses and undesirable sequelae accompany each of several available primary and adjuvant treatment options. The current study explored the effects of primary three-dimensional conformal radiotherapy with or without neoadjuvant hormonal therapy on urinary, bowel, and sexual symptoms and health-related quality of life (HRQOL).


METHODS
A prospective, repeated-measures design study included 100 patients. Data from the Medical Outcomes Study Short Form Health Survey (a measure of general HRQOL) and a 12-item symptom questionnaire were collected before the start of radiotherapy, approximately 1-3 months after completion of treatment, and again approximately 5-10 months after completion of treatment for follow-up.


RESULTS
Patients reported few urinary symptoms after treatment. Bowel frequency and urgency were reported more frequently posttreatment and at follow-up. Erectile difficulties, which were common pretreatment, were reported with increased frequency posttreatment and at follow-up. General HRQOL scores were higher than age-related general population norms for men at all three data collection times, but there were significant losses posttreatment for patients' physical functioning and vitality. At the 5-10-month follow-up, physical functioning remained lower but vitality scores regained some of the losses. A more extended follow-up is needed. Neoadjuvant therapy, which was received before the pretreatment data collection, had a deleterious effect on erectile functioning but no interactive effects with the radiotherapy on symptoms or HRQOL.


CONCLUSIONS
Although patients with a diagnosis of prostate carcinoma experienced increased bowel and sexual dysfunction and decreased vitality after radiotherapy, their HRQOL scores remained at or above age-related general population norms.
Staff
Ilene
I
Institute for Outcomes Research and Evaluation, Hartford Hospital, Hartford, Connecticut 06106, USA. istaff@harthosp.org
Salner
Andrew
A
Bohannon
Richard
R
Panatieri
Pauline
P
Maljanian
Rose
R
D000367:Age Factors; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D007172:Erectile Dysfunction / Q000209:etiology*; D005221:Fatigue; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D011788:Quality of Life; D011832:Radiation Injuries; D020266:Radiotherapy, Conformal / Q000009:adverse effects*
D018931:Antineoplastic Agents, Hormonal