Retrospective analysis of results of p(65)+Be neutron therapy for treatment of prostate adenocarcinoma at the cyclotron of Louvain-la-Leuve. Part II: Side effects and their influence on quality of life measured with QLQ-C30 of EORTC.
OBJECTIVE
Between 1978 and 1998, 533 prostate adenocarcinoma patients were treated with mixed photon-neutron radiotherapy. We report on a retrospective series of patients for whom the side effects of the treatment and their impact on quality of life were assessed by a mailed questionnaire.


METHODS
The European Organization for Research and Treatment of Cancer quality-of-life core questionnaire and a prostate-specific questionnaire were used. Between 1990 and 1996, 308 consecutive patients were treated. Two protocols were used: pelvic fields (50 Gy equivalent photons, 2 Gy/fraction) followed by a prostate boost (66 Gy) or prostate alone. The neutron/photon ratio varied. The questionnaire was mailed to 262 patients presumed to be alive.


RESULTS
Of the 262 patients, 230 replied. Of the 230 patients, 73% had no trouble doing strenuous activities and 4% had trouble with taking a short walk. The overall physical condition and quality-of-life questions received a mean score of 5.2 and 5.3 on a 7-point scale, respectively. Twenty-two percent had bowel movements at least four times daily, and 6% did so six times or more. Retaining stool was a problem in 26%, and only 38% reported full continence; 17% urinated four times or more nightly. Urinary incontinence was scored as "quite a bit" or "very much" in 11% and 5%, respectively. Hematuria and dysuria (pain) were reported by 7% and 16%, respectively, mainly as moderate. Only 28% reported easy erections, but 75% judged the sexual change acceptable. A greater neutron/photon ratio was significantly associated with more bowel problems (p = 0.003).


CONCLUSIONS
Mixed photon-neutron therapy for prostate cancer was associated with significant patient-reported side effects. Their significant effect on patients' quality of life is described.
Scalliet
Pierre G M
PG
Department of Radiation Oncology, Hospital St. Luc, Université Caholique de Louvain, Brussels, Belgium. Scalliet@rbnt.ucl.ac.be
Remouchamps
Vincent
V
Curran
Desmond
D
Ledent
Guy
G
Wambersie
André
A
Richard
Françoise
F
van Cangh
Paul
P
D000230:Adenocarcinoma / Q000503:physiopathology / Q000532:radiotherapy*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003672:Defecation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009502:Neutrons / Q000009:adverse effects* / Q000627:therapeutic use; D017785:Photons / Q000009:adverse effects / Q000627:therapeutic use; D011471:Prostatic Neoplasms / Q000503:physiopathology / Q000532:radiotherapy*; D011788:Quality of Life; D012062:Relative Biological Effectiveness; D012189:Retrospective Studies; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D014554:Urination