title: Image guided hypofractionated radiotherapy and quality of life for localized prostate cancer: prospective longitudinal study in 337 patients.
abstract: OBJECTIVE
  We prospectively analyzed quality of life in a cohort of patients with prostate cancer undergoing a course of hypofractionated image guided radiotherapy.
  
  
  METHODS
  Between August 2006 and January 2011, 337 patients with a median age of 73 years who had cT1-T2N0M0 prostate cancer were eligible for this prospective, longitudinal study of hypofractionated image guided radiotherapy (70.2 Gy/26 fractions) using 1 of 3 image guided radiotherapy modalities (transabdominal ultrasound, x-ray or cone beam computerized tomography) available in our radiation oncology department. Patients completed 4 questionnaires before treatment, and 6, 12 and 24 months later, including the International Index of Erectile Function-5, International Prostate Symptom Score, and EORTC (European Organization for Research and Treatment of Cancer) prostate cancer specific QLQ-PR25 and QLQ-C30.
  
  
  RESULTS
  Patient followup was updated to at least the last questionnaire time point. Median followup was 19 months. Significant deterioration in erectile function on the International Index of Erectile Function-5 was documented with time only in patients without androgen deprivation (p = 0.0002). No change with time was observed in urinary symptom related quality of life on the QLQ-PR25 or International Prostate Symptom Score. Slight deterioration in QLQ-PR25 bowel symptom related quality of life was observed (p = 0.02). Overall QLQ-C30 Global Health Status improved with time (p = 0.03). On univariate analysis it significantly correlated with the maximum RTOG (Radiation Therapy Oncology Group)/EORTC urinary and bowel late toxicity scores after radiotherapy.
  
  
  CONCLUSIONS
  The regimen of hypofractionated image guided radiotherapy with multiple imaging modalities adopted in our radiation oncology department for localized prostate cancer might be a successful strategy for dose escalation with a limited impact on different aspects of quality of life with time.
authors: Department of Radiation Oncology, European Institute of Oncology, Milan, Italy.
authors: Barbara A
authors: BA
authors: Jereczek-Fossa
authors: Luigi
authors: L
authors: Santoro
authors: Dario
authors: D
authors: Zerini
authors: Cristiana
authors: C
authors: Fodor
authors: Barbara
authors: B
authors: Vischioni
authors: Michela
authors: M
authors: Dispinzieri
authors: Isa
authors: I
authors: Bossi-Zanetti
authors: Federica
authors: F
authors: Gherardi
authors: Maria
authors: M
authors: Bonora
authors: Mariangela
authors: M
authors: Caputo
authors: Andrea
authors: A
authors: Vavassori
authors: Raffaella
authors: R
authors: Cambria
authors: Cristina
authors: C
authors: Garibaldi
authors: Federica
authors: F
authors: Cattani
authors: Deliu V
authors: DV
authors: Matei
authors: Gennaro
authors: G
authors: Musi
authors: Ottavio
authors: O
authors: De Cobelli
authors: Roberto
authors: R
authors: Orecchia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003952:Diagnostic Imaging / Q000379:methods; D019583:Dose Fractionation, Radiation; D006801:Humans; D007558:Italy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D018579:Patient Selection; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D011788:Quality of Life; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D012044:Regression Analysis; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome