title: Health-related quality of life 3 years after high-dose intensity-modulated radiotherapy with gold fiducial marker-based position verification.
abstract: OBJECTIVE
  To evaluate the change in quality of life (QoL) 3 years after high-dose intensity-modulated radiotherapy (IMRT) using gold fiducial marker-based position verification in patients with locally advanced prostate cancer.
  
  
  METHODS
  Between October 2003 and November 2004, 95 patients with locally advanced prostate cancer were treated with 76 Gy IMRT with gold-fiducial marker-based position verification. Before treatment (baseline) and 1, 6 and 36 months after RT the QoL was measured using the RAND-36, the European Organization for Research and Treatment of Cancer (EORTC) core questionnaire (QLQ-C30(+3)) and the prostate tumour-specific module (EORTC QLQ-PR25). Changes in QoL with time of > or =10 points were considered clinically relevant.
  
  
  RESULTS
  After 3 years there was a statistically significant improvement in QoL for emotional role restriction and functioning, change in health, mental health and insomnia, compared with baseline. Emotional role restriction increased by >10 points and was therefore clinically relevant, while all other differences were of <10 points. There was a statistically significant deterioration of QoL after 3 years in physical and cognitive functioning, bowel symptoms/function and sexual activity. Only the sexual activity QoL score changed by 12 points and was therefore the only meaningful deterioration in QoL at 3 years after treatment.
  
  
  CONCLUSIONS
  IMRT and accurate position verification provide the possibility to deliver a high irradiation dose to the prostate without clinically relevant deterioration in long-term QoL, except for a persistent decrease in sexual activity score.
authors.affiliation: Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands. i.m.lips@umcutrecht.nl
authors.forename: Irene M
authors.initials: IM
authors.lastname: Lips
authors.forename: Carla H
authors.initials: CH
authors.lastname: van Gils
authors.forename: Uulke A
authors.initials: UA
authors.lastname: van der Heide
authors.forename: Arto E Boeken
authors.initials: AE
authors.lastname: Kruger
authors.forename: Marco
authors.initials: M
authors.lastname: van Vulpen
mesh_terms: D000368:Aged; D006046:Gold; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D019736:Prostheses and Implants; D011788:Quality of Life; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods*; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D011795:Surveys and Questionnaires
chemical_list: D006046:Gold