The impact of acute urinary retention after iodine-125 prostate brachytherapy on health-related quality of life.
OBJECTIVE
To evaluate the impact of acute urinary retention (AUR) in patients treated with (125)I prostate brachytherapy on short- and long-term health-related quality of life (HRQOL); and to assess whether pretreatment HRQOL has additional value in the prediction of AUR.


METHODS
For 127 patients treated with (125)I brachytherapy for localized prostate cancer between December 2000 and June 2003, toxicity and HRQOL data were prospectively collected. Patients received a HRQOL questionnaire at five time points: before and 1 month, 6 months, 1 year, and 6 years after treatment. The questionnaire included the RAND-36 generic health survey, the cancer-specific European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30), the tumor-specific EORTC prostate cancer module (EORTC QLQ-PR25), and the American Urological Association (AUA) symptom index.


RESULTS
Of 127 patients, 13 (10.2%) developed AUR. Patients with AUR had a significantly worse urinary QOL at all time points compared with patients without AUR. The mean difference over time (6 years) between both groups for the EORTC QLQ-PR25 urinary symptom score was 13.0 points (p < 0.001) and for the AUA urinary symptom score was 15.7 points (p = 0.001). Global QOL scores (EORTC QLQ-C30) over time for patients who developed AUR were significantly worse compared with patients without AUR (mean difference 6.7 points; p = 0.043). In multivariate logistic regression analysis, pretreatment International Prostate Symptom Score (p = 0.004) and neoadjuvant hormonal treatment (p = 0.034) were predictors of AUR. Quality of life did not have added predictive value.


CONCLUSIONS
Acute urinary retention after prostate brachytherapy has a significant negative impact on patient's HRQOL up to 6 years after treatment, in terms of both global QOL measures and urinary symptom scores. Furthermore, our results suggest limited value of pretreatment HRQOL measures for the prediction of AUR.
Roeloffzen
Ellen M A
EM
Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands. E.M.A.Roeloffzen@UMCUtrecht.nl
Hinnen
Karel A
KA
Battermann
Jan J
JJ
Monninkhof
Evelyn M
EM
van Roermund
Joep G H
JG
van Gellekom
Marion P R
MP
Frank
Steven J
SJ
van Vulpen
Marco
M
D000208:Acute Disease; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D006304:Health Status; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011788:Quality of Life; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D016055:Urinary Retention / Q000209:etiology*
D007457:Iodine Radioisotopes