Health-related quality of life after adjuvant and salvage postoperative radiotherapy for prostate cancer - a prospective analysis.
OBJECTIVE
The aim of the study was to analyze health-related quality of life changes after postoperative radiotherapy (RT) for prostate cancer.


METHODS
A group of 101 patients has been surveyed prospectively before (time A), at the last day (B), two months after (C) and >1 year after (D) RT using a validated questionnaire (Expanded Prostate Cancer Index Composite) with urinary, bowel, sexual and hormonal domains. The prostatic fossa was treated with a four-field box technique up to a total dose of 66.6 Gy.


RESULTS
While median urinary scores reached baseline levels already two months after radiotherapy (function/bother scores at time A-B-C-D: 94/89-89/75-94/89-94/89; A vs. B: p<0.01), bowel problems needed a longer time to recover (function/bother scores at time A-B-C-D: 96/100-85/89-88/93-96/100; A vs. B/C: p<0.01). Greater bladder volumes inside specific isodoses were associated with temporary significantly lower urinary bother scores and chronically lower urinary incontinence scores. Only 7% of patients reported of erections firm enough for intercourse before RT, so that RT-associated sexual toxicity played a minor role.


CONCLUSIONS
In contrast to bowel symptoms, acute urinary problems recover very soon after the end of postoperative RT. After >1 year, only minor HRQOL changes occurred in comparison to baseline scores.
Pinkawa
Michael
M
Department of Radiation Oncology, RWTH Aachen University, Aachen, Germany. MPinkawa@ukaachen.de
Fischedick
Karin
K
Asadpour
Branka
B
Gagel
Bernd
B
Piroth
Marc D
MD
Holy
Richard
R
Krenkel
Barbara
B
Eble
Michael J
MJ
D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D011788:Quality of Life; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*; D016879:Salvage Therapy; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome