title: 3-D conformal treatment of prostate cancer to 74 Gy vs. high-dose-rate brachytherapy boost: a cross-sectional quality-of-life survey.
abstract: The effects of two modalities of dose-escalated radiotherapy on health-related quality of life (HRQOL) were compared. Forty-one consecutive patients were treated with a 3-D conformal (3-DC) boost to 74 Gy, and 43 with high-dose rate (HDR) brachytherapy boost (2x9 Gy), following 3-D conformal treatment to 46 Gy. Median age was 70 years in both groups, median initial PSA was 7.9 microg/l in 3-DC boost patients and 8.1 microg/l in HDR boost patients. Stage was <or=T2 in 66% and 67% and Gleason score was >or=7 in 52% and 47%, respectively. HRQOL was assessed cross-sectionally using EORTC QLQ-C30 and organ-specific PR25 modules 3--32 (median 19) and 4--25 (median 14) months after treatment, respectively. Questionnaires were completed by 93% and 97% of patients, respectively. Diarrhea and insomnia scores were significantly increased in both groups. In the PR25 module, scores of 3-DC boost and HDR boost patients for urinary, bowel and treatment-related symptoms were similar. Among responders, 34% of 3-DC boost patients and 86% of HDR boost patients had severe erectile problems. Dose escalation in prostate cancer by either 3-DC boost to 74 Gy or HDR brachytherapy boost appears to result in similar HRQOL profiles.
authors.affiliation: Department of Radiation Oncology, University of Würzburg, Germany. vordermark_d@klinik.uni-wuerzburg.de
authors.forename: Dirk
authors.initials: D
authors.lastname: Vordermark
authors.forename: Jörn
authors.initials: J
authors.lastname: Wulf
authors.forename: Klaus
authors.initials: K
authors.lastname: Markert
authors.forename: Kurt
authors.initials: K
authors.lastname: Baier
authors.forename: Oliver
authors.initials: O
authors.lastname: Kölbl
authors.forename: Gabriele
authors.initials: G
authors.lastname: Beckmann
authors.forename: Klaus
authors.initials: K
authors.lastname: Bratengeier
authors.forename: Michael
authors.initials: M
authors.lastname: Noe
authors.forename: Georg
authors.initials: G
authors.lastname: Schön
authors.forename: Michael
authors.initials: M
authors.lastname: Flentje
mesh_terms: D001918:Brachytherapy / Q000379:methods*; D003430:Cross-Sectional Studies; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011788:Quality of Life; D011829:Radiation Dosage; D020266:Radiotherapy, Conformal / Q000379:methods*; D011795:Surveys and Questionnaires