title: Quality of life after prostate cancer treatments in patients comparable at baseline.
abstract: BACKGROUND
  Previous studies on the effects of different prostate cancer treatments on quality of life, were confounded because patients were not comparable. This study examined treatment effects in more comparable groups.
  
  
  METHODS
  From 2008-2011, 240 patients with localised prostate cancer were selected to be eligible for both radical prostatectomy (RP) and external beam radiotherapy (EBRT). Brachytherapy (BT) was a third option for some. Health-related quality of life was measured by expanded prostate cancer index composite (EPIC) up to 12 months after treatment.
  
  
  RESULTS
  In the sexual domain, RP led to worse summary scores (P<0.001) and more often to a clinically relevant deterioration from baseline than BT and EBRT (79%, 33%, 34%, respectively). In the urinary domain, RP also led to worse summary scores (P=0.014), and more deterioration from baseline (41%, 12%, 19%, respectively). Only on the irritative/obstructive urinary scale, more BT patients (40%) showed a relevant deterioration than RP (17%) and EBRT patients (11%). In the bowel domain, the treatment effects did not differ.
  
  
  CONCLUSIONS
  This study provides a more unbiased comparison of treatment effects, as men were more comparable at baseline. Our results suggest that, for quality of life, radiotherapy is as least as good an option as RP for treating localised prostate cancer.
authors.affiliation: Department of Radiation Oncology, Radboud University Medical Centre, PO Box 9101, Nijmegen, The Netherlands. J.vanTol@rther.umcn.nl
authors.forename: J J
authors.initials: JJ
authors.lastname: van Tol-Geerdink
authors.forename: J W H
authors.initials: JW
authors.lastname: Leer
authors.forename: I M
authors.initials: IM
authors.lastname: van Oort
authors.forename: E J N T
authors.initials: EJ
authors.lastname: van Lin
authors.forename: P C
authors.initials: PC
authors.lastname: Weijerman
authors.forename: H
authors.initials: H
authors.lastname: Vergunst
authors.forename: J A
authors.initials: JA
authors.lastname: Witjes
authors.forename: P F M
authors.initials: PF
authors.lastname: Stalmeier
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D007172:Erectile Dysfunction; D006304:Health Status; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014549:Urinary Incontinence