3-D conformal treatment of prostate cancer to 74 Gy vs. high-dose-rate brachytherapy boost: a cross-sectional quality-of-life survey.
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.
Vordermark
Dirk
D
Department of Radiation Oncology, University of Würzburg, Germany. vordermark_d@klinik.uni-wuerzburg.de
Wulf
Jörn
J
Markert
Klaus
K
Baier
Kurt
K
Kölbl
Oliver
O
Beckmann
Gabriele
G
Bratengeier
Klaus
K
Noe
Michael
M
Schön
Georg
G
Flentje
Michael
M
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