title: Quality of life after radical radiotherapy for prostate cancer: longitudinal study from a randomised trial of external beam radiotherapy alone or in combination with high dose rate brachytherapy.
abstract: OBJECTIVE
  To compare prospective, long-term quality of life in patients randomised to external beam radiotherapy (EBRT) alone or with a boost of high dose rate (HDR) brachytherapy.
  
  
  METHODS
  In total, 216 patients participating in the UK randomised trial of EBRT ± HDR brachytherapy were included in this analysis. EBRT delivering 55 Gy in 20 fractions was compared with EBRT followed by HDR brachytherapy of 2 × 8.5 Gy. Quality of life was assessed using the Functional Assessment of Cancer Therapy-Prostate (FACT-P) and FACT-G (General) questionnaires, administered before radiotherapy, at 6 months and bi-annually thereafter. Differences in mean FACT global scores and erectile function between treatment arms were compared using chi-squared tests.
  
  
  RESULTS
  Over a 10.5 year follow-up, no difference in FACT-G, FACT-P or Trial Outcome Index (TOI) scores was seen between treatments and means were similar to their pretreatment values. Mean erectile function scores in arm 2 were similar to arm 1, but were significantly lower than the pretreatment mean (P ≤ 0.002). There was no evidence that quality of life deteriorated with increasing follow-up time in any of the four FACT domains.
  
  
  CONCLUSIONS
  The improved biochemical control of disease seen in these patients with EBRT + HDR brachytherapy coupled with equitoxic early and late urinary and bowel morbidity, indicate a therapeutic advantage, which has now been confirmed by the results for general and prostate-related quality of life changes, despite a decline in erectile function.
authors: Cancer Centre, Mount Vernon Hospital, Northwood, Middlesex, UK
authors: P J
authors: PJ
authors: Hoskin
authors: A M
authors: AM
authors: Rojas
authors: P J
authors: PJ
authors: Ostler
authors: R
authors: R
authors: Hughes
authors: G J
authors: GJ
authors: Lowe
authors: L
authors: L
authors: Bryant
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010166:Palliative Care; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011788:Quality of Life; D016879:Salvage Therapy; D016896:Treatment Outcome