title: Patient-reported Urinary, Bowel, and Sexual Function After Hypofractionated Intensity-modulated Radiation Therapy for Prostate Cancer: Results From a Randomized Trial.
abstract: OBJECTIVE
  Hypofractionated prostate radiotherapy may increase biologically effective dose delivered while shortening treatment duration, but information on patient-reported urinary, bowel, and sexual function after dose-escalated hypofractionated radiotherapy is limited. We report patient-reported outcomes (PROs) from a randomized trial comparing hypofractionated and conventional prostate radiotherapy.
  
  
  METHODS
  Men with localized prostate cancer were enrolled in a trial that randomized men to either conventionally fractionated intensity-modulated radiation therapy (CIMRT, 75.6 Gy in 1.8 Gy fractions) or to dose-escalated hypofractionated IMRT (HIMRT, 72 Gy in 2.4 Gy fractions). Questionnaires assessing urinary, bowel, and sexual function were completed pretreatment and at 2, 3, 4, and 5 years after treatment.
  
  
  RESULTS
  Of 203 eligible patients, 185 were evaluable for PROs. A total of 173 completed the pretreatment questionnaire (82 CIMRT, 91 HIMRT) and 102 completed the 2-year questionnaire (46 CIMRT, 56 HIMRT). Patients who completed PROs were similar to those who did not complete PROs (all P>0.05). Patient characteristics, clinical characteristics, and baseline symptoms were well balanced between the treatment arms (all P>0.05). There was no difference in patient-reported bowel (urgency, control, frequency, or blood per rectum), urinary (dysuria, hematuria, nocturia, leakage), or sexual symptoms (erections firm enough for intercourse) between treatment arms at 2, 3, 4, and 5 years after treatment (all P>0.01). Concordance between physician-assessed toxicity and PROs varied across urinary and bowel domains.
  
  
  CONCLUSIONS
  We did not detect an increase in patient-reported urinary, bowel, and sexual symptom burden after dose-escalated intensity-modulated prostate radiation therapy using a moderate hypofractionation regimen (72 Gy in 2.4 Gy fractions) compared with conventionally fractionated radiation.
authors.affiliation: Departments of Radiation Oncology and Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Hoffman
authors.forename: Heath
authors.initials: H
authors.lastname: Skinner
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Pugh
authors.forename: Khinh R
authors.initials: KR
authors.lastname: Voong
authors.forename: Lawrence B
authors.initials: LB
authors.lastname: Levy
authors.forename: Seungtaek
authors.initials: S
authors.lastname: Choi
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Frank
authors.forename: Andrew K
authors.initials: AK
authors.lastname: Lee
authors.forename: Usama
authors.initials: U
authors.lastname: Mahmood
authors.forename: Sean E
authors.initials: SE
authors.lastname: McGuire
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Schlembach
authors.forename: Weiliang
authors.initials: W
authors.lastname: Du
authors.forename: Jennifer
authors.initials: J
authors.lastname: Johnson
authors.forename: Rajat J
authors.initials: RJ
authors.lastname: Kudchadker
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Kuban
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D011379:Prognosis; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D000069473:Radiation Dose Hypofractionation; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D012002:Rectal Diseases / Q000175:diagnosis / Q000209:etiology*; D014555:Urination Disorders / Q000175:diagnosis / Q000209:etiology*