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.
Harvard Radiation Oncology Program, Boston, MA 02115, USA. pnguyen@LROC.harvard.edu
Paul L
PL
Nguyen
Ronald C
RC
Chen
Jack A
JA
Clark
Robert A
RA
Cormack
Marian
M
Loffredo
Elizabeth
E
McMahon
Angela U
AU
Nguyen
W Warren
WW
Suh
Clare M
CM
Tempany
Anthony V
AV
D'Amico
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