title: The impact of gastrointestinal and genitourinary toxicity on health related quality of life among irradiated prostate cancer patients.
abstract: OBJECTIVE
  To determine the impact of late radiation-induced toxicity on health-related quality of life (HRQoL) among patients with prostate cancer.
  
  
  METHODS
  The study sample was composed of 227 patients, treated with external beam radiotherapy. Common Terminology Criteria for Adverse Events version 3.0 were used to grade late genitourinary and gastrointestinal toxicity. The European Organization for Research and Treatment of Cancer Quality of life Questionnaire C30 (EORTC QLQ-C30) was used to assess HRQoL at baseline, and 6, 12 and 24 months after completion of radiotherapy. Statistical analysis was performed using a multivariate analysis of variance (MANOVA).
  
  
  RESULTS
  Urinary incontinence and rectal discomfort significantly affected HRQoL. The impact of urinary incontinence on HRQoL was most pronounced 6 months after radiotherapy and gradually decreased over time. The impact of rectal discomfort on HRQoL was predominant at 6 months after radiotherapy, decreased at 12 months and increased again 2 years after radiotherapy. No significant impact on HRQoL was observed for any of the other toxicity endpoints, or non-toxicity related factors such as hormonal therapy, radiotherapy technique or age.
  
  
  CONCLUSIONS
  Urinary incontinence and rectal discomfort have a significant impact on HRQoL. Prevention of these side effects may likely improve quality of life of prostate cancer patients after completion of treatment.
authors.affiliation: Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands; Hanze University of Applied Sciences, Professorship in Health Care and Nursing, Groningen, The Netherlands. Electronic address: schaakew@umcg.nl.
authors.forename: Wouter
authors.initials: W
authors.lastname: Schaake
authors.affiliation: Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Erwin M
authors.initials: EM
authors.lastname: Wiegman
authors.affiliation: Hanze University of Applied Sciences, Professorship in Health Care and Nursing, Groningen, The Netherlands.
authors.forename: Martijn
authors.initials: M
authors.lastname: de Groot
authors.affiliation: Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Hans Paul
authors.initials: HP
authors.lastname: van der Laan
authors.affiliation: Hanze University of Applied Sciences, Professorship in Health Care and Nursing, Groningen, The Netherlands; Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Cees P
authors.initials: CP
authors.lastname: van der Schans
authors.affiliation: Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Alfons C M
authors.initials: AC
authors.lastname: van den Bergh
authors.affiliation: Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Langendijk
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000503:physiopathology; D041981:Gastrointestinal Tract / Q000503:physiopathology / Q000528:radiation effects*; D006304:Health Status; D006801:Humans; D008297:Male; D052801:Male Urogenital Diseases / Q000209:etiology / Q000503:physiopathology; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011788:Quality of Life; D011832:Radiation Injuries / Q000209:etiology* / Q000503:physiopathology*; D014566:Urogenital System / Q000503:physiopathology / Q000528:radiation effects*
keywords: Gastrointestinal side effects; Genitourinary side effects; Health-related quality of life; Prostate cancer; Radiotherapy