title: Patient-reported quality of life after stereotactic body radiation therapy versus moderate hypofractionation for clinically localized prostate cancer.
abstract: Evaluate changes in bowel, urinary and sexual patient-reported quality of life following treatment with moderately hypofractionated radiotherapy (<5Gray/fraction) or stereotactic body radiation therapy (SBRT;5-10Gray/fraction) for prostate cancer.
  
  
  
  In a pooled multi-institutional analysis of men treated with moderate hypofractionation or SBRT, we compared minimally detectable difference in bowel, urinary and sexual quality of life at 1 and 2years using chi-squared analysis and logistic regression.
  
  
  
  378 men received moderate hypofractionation compared to 534 men who received SBRT. After 1year, patients receiving moderate hypofractionation were more likely to experience worsening in bowel symptoms (39.5%) compared to SBRT (32.5%; p=.06), with a larger difference at 2years (37.4% versus 25.3%, p=.002). Similarly, patients receiving moderate fractionation had worsening urinary symptom score compared to patients who underwent SBRT at 1 and 2years (34.7% versus 23.1%, p<.001; and 32.8% versus 14.0%, p<.001). There was no difference in sexual symptom score at 1 or 2years. After adjusting for age and cancer characteristics, patients receiving SBRT were less likely to experience worsening urinary symptom scores at 2years (odds ratio: 0.24[95%CI: 0.07-0.79]).
  
  
  
  Patients who received SBRT or moderate hypofractionation have similar patient-reported change in bowel and sexual symptoms, although there was worse change in urinary symptoms for patients receiving moderate hypofractionation.
authors.affiliation: Department of Therapeutic Radiology, Yale School of Medicine, New Haven, United States.
authors.forename: Skyler Bryce
authors.initials: SB
authors.lastname: Johnson
authors.affiliation: Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, United States.
authors.forename: Pamela R
authors.initials: PR
authors.lastname: Soulos
authors.affiliation: 21st Century Oncology, Fort Myers, United States.
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Shafman
authors.affiliation: 21st Century Oncology, Fort Myers, United States.
authors.forename: Constantine A
authors.initials: CA
authors.lastname: Mantz
authors.affiliation: 21st Century Oncology, Fort Myers, United States.
authors.forename: Arie P
authors.initials: AP
authors.lastname: Dosoretz
authors.affiliation: 21st Century Oncology, Fort Myers, United States.
authors.forename: Rudi
authors.initials: R
authors.lastname: Ross
authors.affiliation: 21st Century Oncology, Fort Myers, United States.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Finkelstein
authors.affiliation: Georgetown University Hospital, Washington, United States.
authors.forename: Sean P
authors.initials: SP
authors.lastname: Collins
authors.affiliation: Georgetown University Hospital, Washington, United States.
authors.forename: Simeng
authors.initials: S
authors.lastname: Suy
authors.affiliation: Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, United States.
authors.forename: Jeffrey V
authors.initials: JV
authors.lastname: Brower
authors.affiliation: Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, United States.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ritter
authors.affiliation: University of California, Los Angeles-David Geffen School of Medicine, United States.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: King
authors.affiliation: University of California, Los Angeles-David Geffen School of Medicine, United States.
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Kupelian
authors.affiliation: Fox Chase Cancer Center, Philadelphia, United States.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Horwitz
authors.affiliation: Department of Radiation Oncology, Miller School of Medicine, University of Miami, United States.
authors.forename: Alan
authors.initials: A
authors.lastname: Pollack
authors.affiliation: Department of Radiation Oncology, Miller School of Medicine, University of Miami, United States.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Abramowitz
authors.affiliation: Fox Chase Cancer Center, Philadelphia, United States.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Hallman
authors.affiliation: McGill University Health Center, Montreal, Canada.
authors.forename: Sergio
authors.initials: S
authors.lastname: Faria
authors.affiliation: Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, United States.
authors.forename: Cary P
authors.initials: CP
authors.lastname: Gross
authors.affiliation: Department of Therapeutic Radiology, Yale School of Medicine, New Haven, United States; Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, United States. Electronic address: james.b.yu@yale.edu.
authors.forename: James B
authors.initials: JB
authors.lastname: Yu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019583:Dose Fractionation, Radiation; D006801:Humans; D007422:Intestines / Q000528:radiation effects; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D058958:Organs at Risk / Q000528:radiation effects; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000534:rehabilitation; D011788:Quality of Life; D000069473:Radiation Dose Hypofractionation; D011832:Radiation Injuries / Q000209:etiology; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D014551:Urinary Tract / Q000528:radiation effects
keywords: Hypofractionated; Prostate cancer; Quality of life; Radiation; SBRT