title: Patient-reported outcomes of prostate high-dose-rate brachytherapy boost comparing an outpatient and inpatient protocol: a two-center chronologic cohort study.
abstract: OBJECTIVE
  To determine patients' self-reported experiences of outpatient high-dose-rate prostate brachytherapy boost, and compare with previous cohort treated as inpatients.
  
  
  METHODS
  Using the Prostate Brachytherapy Questionnaire, we previously examined patients' subjective experience of the brachytherapy procedure when it involved one implant and hospitalization with the template in situ for 2 days (Group 1). The protocol was subsequently changed to two implants, 2 weeks apart as outpatients. Fifty-eight patients treated with the new protocol (Group 2) completed the same questionnaire. We compared the self-reported experiences between Groups 1 and 2 and also between the first and second implant for those in Group 2. Our hypothesis was that the worst rated issues in Group 1 might be reduced with the new approach.
  
  
  RESULTS
  Group 2 patients were less troubled overall by the procedure (mean scores 2.3 vs. 3.2, p=0.0293). Specifically, they were less troubled by "discomfort" (2.8 vs. 3.8, p=0.0254); "being stuck in bed" (1.7 vs. 4.2 p<0.0001); "feeling helpless" (1.3 vs. 2.8, p=0.0009); "fear of opening my bowels" (2.1 vs. 3.3, p=0.0055); and "fear of coping with the implant" (1.3 vs. 2.5, p=0.0004). There was no significant increase in "thought of implant" or "fear of implant" before the second implant. However, more patients rated worse than expected "fear of passing urine" during the second implant.
  
  
  CONCLUSIONS
  Patients rated high-dose-rate brachytherapy less troublesome when delivered as outpatient with two implants, 2 weeks apart than as inpatient over 3 days, despite the additional invasive procedure and anesthesia.
authors.affiliation: Department of Radiation Oncology, Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. james.chen@ctc.usyd.edu.au
authors.forename: James Y
authors.initials: JY
authors.lastname: Chen
authors.forename: George
authors.initials: G
authors.lastname: Hruby
authors.forename: Martin R
authors.initials: MR
authors.lastname: Stockler
authors.forename: Nitya
authors.initials: N
authors.lastname: Patanjali
authors.forename: Joseph
authors.initials: J
authors.lastname: Bucci
authors.forename: Gino
authors.initials: G
authors.lastname: Perez
authors.forename: John A
authors.initials: JA
authors.lastname: Loadsman
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sheehan
mesh_terms: D000230:Adenocarcinoma / Q000532:radiotherapy*; D000368:Aged; D000553:Ambulatory Care; D001918:Brachytherapy / Q000379:methods*; D015331:Cohort Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D016896:Treatment Outcome