Patient-reported quality of life after salvage brachytherapy for radio-recurrent prostate cancer: A prospective Phase II study.
BACKGROUND
Patient-reported quality of life (QOL) after salvage brachytherapy for radiorecurrent prostate cancer has not been well-characterized prospectively.


METHODS
We examined 25 men who recurred after primary radiotherapy for prostate cancer and received MRI-guided salvage brachytherapy as part of a prospective Phase II study. These patients received prospectively a validated patient-reported QOL questionnaire to fill out at baseline, as well as 3, 15, and 27 months after re-irradiation to determine the degree of sexual, bowel, and urinary dysfunction (maximum dysfunction score=100).


RESULTS
On average, sexual function continued to decline with time, and patients had significantly worse sexual function scores at 27 months than baseline (p=0.01). Although bowel and urinary symptoms worsened acutely at 3 or 15 months, they showed on average some improvement by 27 months, and there were no significant differences between baseline and 27-month urinary or bowel scores. An interval to re-irradiation less than 4.5 years and prior brachytherapy were each associated significantly with the largest decrements in bowel function (p=0.035).


CONCLUSIONS
Similar to the patterns seen in the de novo setting, patients who receive salvage brachytherapy report a worsening of bowel and urinary symptoms followed by some improvement by 27 months, while sexual function steadily declines over time. Interval to re-irradiation and type of prior radiation received may be used to counsel and optimize selection of men for salvage brachytherapy with regard to QOL endpoints.
Nguyen
Paul L
PL
Harvard Radiation Oncology Program, Boston, MA 02115, USA. pnguyen@LROC.harvard.edu
Chen
Ronald C
RC
Clark
Jack A
JA
Cormack
Robert A
RA
Loffredo
Marian
M
McMahon
Elizabeth
E
Nguyen
Angela U
AU
Suh
W Warren
WW
Tempany
Clare M
CM
D'Amico
Anthony V
AV
D001918:Brachytherapy / Q000009:adverse effects*; D007172:Erectile Dysfunction / Q000209:etiology; D005242:Fecal Incontinence / Q000209:etiology; D006801:Humans; D053783:Magnetic Resonance Imaging, Interventional; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000532:radiotherapy*; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000532:radiotherapy*; D011788:Quality of Life; D016879:Salvage Therapy; D014549:Urinary Incontinence / Q000209:etiology
D017430:Prostate-Specific Antigen