Health-related quality of life after permanent I-125 brachytherapy and conformal external beam radiotherapy for prostate cancer--a matched-pair comparison.
OBJECTIVE
The aim of the study was to compare quality of life after permanent I-125 brachytherapy (BT) and external beam radiotherapy (EBRT) for prostate cancer.


METHODS
A group of 104 patients (52 in each group) have been surveyed prospectively before EBRT/BT (time A), at the last day of EBRT (70.2-72.0 Gy) or one month after BT (time B), and a median time of 16 months after EBRT/BT (time C) using a validated questionnaire (Expanded Prostate Cancer Index Composite). Pairs were matched according to the following criteria: age +/-5 years, prostate volume +/-10 cc, use of antiandrogens, and erectile function.


RESULTS
Urinary function/bother scores decreased significantly more after BT both at time B and time C. Bowel function/bother scores tended to be higher after BT, with a lower percentage of patients with painful bowel movements (BT: 12%/27%/15%; EBRT: 19%/52%/35% at time A/B/C; p<0.05 for differences at times B/C) and rectal bleeding (BT: 12%/12%/12%; EBRT: 8%/14%/17%). No difference concerning erectile dysfunction was found (67% vs. 61% with preserved erections firm enough for intercourse after BT vs. EBRT at time C).


CONCLUSIONS
BT was associated with higher urinary, but lower rectal toxicity. The risk of treatment-associated erectile dysfunction did not differ between these methods.
Pinkawa
Michael
M
Department of Radiation Oncology, RWTH Aachen University, Aachen, Germany. MPinkawa@ukaachen.de
Asadpour
Branka
B
Piroth
Marc D
MD
Gagel
Bernd
B
Nussen
Sandra
S
Kehl
Mareike
M
Borchers
Holger
H
Jakse
Gerhard
G
Eble
Michael J
MJ
D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects*; D006304:Health Status; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000523:psychology* / Q000532:radiotherapy*; D011788:Quality of Life; D020266:Radiotherapy, Conformal / Q000009:adverse effects*
D007457:Iodine Radioisotopes