Health-related quality of life in men receiving prostate brachytherapy on RTOG 98-05.
OBJECTIVE
To prospectively assess health-related quality of life (HRQOL) during the first year after treatment with prostate brachytherapy (PB) alone for T1c-2a prostate cancer.


METHODS
Ninety-eight patients from 24 institutions were eligible and properly entered on this study. All patients were treated with PB alone using I-125 (Oncura Model 6711). The prescription dose was 145 Gy. Three separate health-related quality of life questionnaires (HRQOL) (Functional Assessment of Cancer Therapy-Prostate [FACT-P], Sexual Adjustment Questionnaire [SAQ], and International Prostate Symptom Score [IPSS]) were self-administered before and after PB (baseline; 3, 6, 9, and 12 months after PB). The standard error of the mean (SEM) was used to analyze changes in HRQOL scores over time. Patients who improved greater than the SEM were categorized as improved; patients that declined greater than the SEM were categorized as declined; patients were otherwise categorized as stable. All changes are measured using the pretreatment HRQOL score as baseline.


RESULTS
The percentage of men who reported the ability to have an erection decreased from 73% at baseline (65% unassisted, 8% assisted) to 57% at 1 year (36% unassisted, 21% assisted). The rate of urinary incontinence increased to 14% at 6 months but had decreased to 1% at the 12-month follow-up. At 1 year after PB, 80% of men reported decreased sexual functioning according to SAQ scores. More than 60% of men reported decreased urinary function at 12 months compared with baseline.


CONCLUSIONS
This article represents the first prospective, multi-institutional study of HRQOL in men treated with PB and demonstrates that patients undergoing PB have a very high overall HRQOL. The rate of incontinence by 1 year after PB is low, but many patients continue to have obstructive symptoms at 1 year. Although 78% of 1-year respondents state that they can achieve an erection with or without assistance, almost 50% report a decrease in sexual function.
Department of Radiation Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111-2497, USA. S_Feigenberg@fccc.edu
Steven J
SJ
Feigenberg
W Robert
WR
Lee
Michelle L
ML
Desilvio
Kathryn
K
Winter
Thomas M
TM
Pisansky
Deborah Watkins
DW
Bruner
Colleen
C
Lawton
Gerald
G
Morton
Madhava
M
Baikadi
Howard
H
Sandler
D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects*; D007172:Erectile Dysfunction / Q000209:etiology; D006304:Health Status; D006801:Humans; D007457:Iodine Radioisotopes; D017567:Karnofsky Performance Status; D008297:Male; D010410:Penile Erection; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology
D007457:Iodine Radioisotopes