title: Quality of life after whole pelvic versus prostate-only external beam radiotherapy for prostate cancer: a matched-pair comparison.
abstract: OBJECTIVE
  Comparison of health-related quality of life after whole pelvic (WPRT) and prostate-only (PORT) external beam radiotherapy for prostate cancer.
  
  
  METHODS
  A group of 120 patients (60 in each group) was surveyed prospectively before radiation therapy (RT) (time A), at the last day of RT (time B), at a median time of 2 months (time C) and >1 year after RT (time D) using a validated questionnaire (Expanded Prostate Cancer Index Composite). All patients were treated with 1.8- to 2.0-Gy fractions up to 70.2 to 72.0 Gy with or without WPRT up to 45 to 46 Gy. Pairs were matched according to the following criteria: age±5 years, planning target volume±10 cc (considering planning target volume without pelvic nodes for WPRT patients), urinary/bowel/sexual function score before RT±10, and use of antiandrogens.
  
  
  RESULTS
  With the exception of prognostic risk factors, both groups were well balanced with respect to baseline characteristics. No significant differences were found with regard to urinary and sexual score changes. Mean bladder function scores reached baseline levels in both patient subgroups after RT. However, bowel function scores decreased significantly more for patients after WPRT than in those receiving PORT at all times (p<0.01, respectively). Significant differences were found for most items in the bowel domain in the acute phase. At time D, patients after WPRT reported rectal urgency (>once a day in 15% vs. 3%; p=0.03), bloody stools (≥half the time in 7% vs. 0%; p=0.04) and frequent bowel movements (>two on a typical day in 32% vs. 7%; p<0.01) more often than did patients after PORT.
  
  
  CONCLUSIONS
  In comparison to PORT, WPRT (larger bladder and rectum volumes in medium dose levels, but similar volumes in high dose levels) was associated with decreased bowel quality of life in the acute and chronic phases after treatment but remained without adverse long-term urinary effects.
authors.affiliation: Department of Radiotherapy, RWTH Aachen University, Aachen, Germany. mpinkawa@ukaachen.de
authors.forename: Michael
authors.initials: M
authors.lastname: Pinkawa
authors.forename: Marc D
authors.initials: MD
authors.lastname: Piroth
authors.forename: Richard
authors.initials: R
authors.lastname: Holy
authors.forename: Karin
authors.initials: K
authors.lastname: Fischedick
authors.forename: Jens
authors.initials: J
authors.lastname: Klotz
authors.forename: Dalma
authors.initials: D
authors.lastname: Székely-Orbán
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Eble
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006304:Health Status; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009929:Organ Size / Q000528:radiation effects; D010388:Pelvis; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011788:Quality of Life; D011879:Radiotherapy Dosage; D012007:Rectum / Q000033:anatomy & histology / Q000528:radiation effects*; D012725:Sexual Behavior / Q000528:radiation effects; D011795:Surveys and Questionnaires; D001743:Urinary Bladder / Q000033:anatomy & histology / Q000528:radiation effects*