title: Health-related quality of life after stereotactic body radiation therapy for localized prostate cancer: results from a multi-institutional consortium of prospective trials.
abstract: OBJECTIVE
  To evaluate the early and late health-related quality of life (QOL) outcomes among prostate cancer patients following stereotactic body radiation therapy (SBRT).
  
  
  METHODS
  Patient self-reported QOL was prospectively measured among 864 patients from phase 2 clinical trials of SBRT for localized prostate cancer. Data from the Expanded Prostate Cancer Index Composite (EPIC) instrument were obtained at baseline and at regular intervals up to 6 years. SBRT delivered a median dose of 36.25 Gy in 4 or 5 fractions. A short course of androgen deprivation therapy was given to 14% of patients.
  
  
  RESULTS
  Median follow-up was 3 years and 194 patients remained evaluable at 5 years. A transient decline in the urinary and bowel domains was observed within the first 3 months after SBRT which returned to baseline status or better within 6 months and remained so beyond 5 years. The same pattern was observed among patients with good versus poor baseline function and was independent of the degree of early toxicities. Sexual QOL decline was predominantly observed within the first 9 months, a pattern not altered by the use of androgen deprivation therapy or patient age.
  
  
  CONCLUSIONS
  Long-term outcome demonstrates that prostate SBRT is well tolerated and has little lasting impact on health-related QOL. A transient and modest decline in urinary and bowel QOL during the first few months after SBRT quickly recovers to baseline levels. With a large number of patients evaluable up to 5 years following SBRT, it is unlikely that unexpected late adverse effects will manifest themselves.
authors.affiliation: Department of Radiation Oncology, University of California, Los Angeles, California. Electronic address: crking@mednet.ucla.edu.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: King
authors.forename: Sean
authors.initials: S
authors.lastname: Collins
authors.forename: Donald
authors.initials: D
authors.lastname: Fuller
authors.forename: Pin-Chieh
authors.initials: PC
authors.lastname: Wang
authors.forename: Patrick
authors.initials: P
authors.lastname: Kupelian
authors.forename: Michael
authors.initials: M
authors.lastname: Steinberg
authors.forename: Alan
authors.initials: A
authors.lastname: Katz
mesh_terms: D000368:Aged; D019985:Benchmarking; D006304:Health Status; D006801:Humans; D008297:Male; D058958:Organs at Risk / Q000528:radiation effects*; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011788:Quality of Life; D011829:Radiation Dosage; D016634:Radiosurgery / Q000009:adverse effects*; D061089:Radiotherapy, Image-Guided / Q000379:methods; D020127:Recovery of Function; D012007:Rectum / Q000528:radiation effects; D057566:Self Report; D019529:Sexuality / Q000528:radiation effects; D013997:Time Factors; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000528:radiation effects