TY - JOUR
T1 - Patient-reported quality of life after stereotactic body radiotherapy (SBRT), intensity modulated radiotherapy (IMRT), and brachytherapy
AU - PROSTQA Study Consortium
AU - Evans, Joseph R.
AU - Zhao, Shuang
AU - Daignault, Stephanie
AU - Sanda, Martin G.
AU - Michalski, Jeff
AU - Sandler, Howard M.
AU - Kuban, Deborah A.
AU - Ciezki, Jay
AU - Kaplan, Irving D.
AU - Zietman, Anthony L.
AU - Hembroff, Larry
AU - Feng, Felix Y.
AU - Suy, Simeng
AU - Skolarus, Ted A.
AU - McLaughlin, Patrick W.
AU - Wei, John T.
AU - Dunn, Rodney L.
AU - Finkelstein, Steven E.
AU - Mantz, Constantine A.
AU - Collins, Sean P.
AU - Hamstra, Daniel A.
N1 - Funding Information:
We acknowledge PROSTQA Data Coordinating Center Project Management by Kyle Davis and Jill Hardy, MS (Michigan State University, East Lansing, MI), Erin Najuch and Jonathan Chipman (Dana Farber Cancer Institute, Boston, MA), Datta Patil, MBBS, MPH (Emory, Atlanta, GA), and Catrina Crociani, MPH (Beth Israel Deaconess Medical Center, Boston, MA), grant administration by Beth Doiron, BA (Beth Israel Deaconess Medical Center, Boston, MA), and technical support from coordinators at each clinical site. We would like to thank the study participants. Without them this study would not have been possible.
Funding Information:
PROSTQA Consortium study group (Study Investigators, DCC and Coordinators): The PROSTQA Consortium includes contributions in cohort design, patient accrual and follow-up from the following investigators: Meredith Regan (Dana Farber Cancer Institute, Boston, MA); Larry Hembroff and Douglas Roberts (Michigan State University, East Lansing, MI); John T. Wei, Dan Hamstra, Rodney Dunn, Laurel Northouse and David Wood (University of Michigan, Ann Arbor, MI); Eric A Klein and Jay Ciezki (Cleveland Clinic, Cleveland, OH); Jeff Michalski and Gerald Andriole (Washington University, St. Louis, MO); Mark Litwin and Chris Saigal (University of California-Los Angeles Medical Center, Los Angeles, CA); Thomas Greenfield, PhD (Eneryville, CA), Louis Pisters and Deborah Kuban (MD Anderson Cancer Center, Houston, TX); Howard Sandler (Cedars Sinai Medical Center, Los Angeles, CA); Jim Hu and Adam Kibel (Brigham and Women''s Hospital, Boston, MA); Douglas Dahl and Anthony Zietman (Massachusetts General Hospital, Boston, MA); Peter Chang, Andrew Wagner, and Irving Kaplan (Beth Israel Deaconess Medical Center, Boston, MA) and Martin G. Sanda (Emory, Atlanta, GA). We acknowledge PROSTQA Data Coordinating Center Project Management by Kyle Davis and Jill Hardy, MS (Michigan State University, East Lansing, MI), Erin Najuch and Jonathan Chipman (Dana Farber Cancer Institute, Boston, MA), Datta Patil, MBBS, MPH (Emory, Atlanta, GA), and Catrina Crociani, MPH (Beth Israel Deaconess Medical Center, Boston, MA), grant administration by Beth Doiron, BA (Beth Israel Deaconess Medical Center, Boston, MA), and technical support from coordinators at each clinical site. We would like to thank the study participants. Without them this study would not have been possible.
Funding Information:
PROST-QA Consortium Funded by National Institutes of Health Grants R01 CA95662 , RC1 CA146596 , and RC1 EB011001 . The study sponsors played no role in the study design, in the collection, analysis and interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication.
Publisher Copyright:
© 2015 Elsevier Ireland Ltd.
PY - 2015
Y1 - 2015
N2 - Background and purpose Stereotactic body radiotherapy (SBRT) is being used for prostate cancer, but concerns persist about toxicity compared to other radiotherapy options. Materials and methods We conducted a multi-institutional pooled cohort analysis of patient-reported quality of life (QOL) [EPIC-26] before and after intensity-modulated radiotherapy (IMRT), brachytherapy, or SBRT for localized prostate cancer. Data were analyzed by mean domain score, minimal clinically detectable difference (MCD) in domain score, and multivariate analyses to determine factors associated with domain scores at 2-years. Results Data were analyzed from 803 patients at baseline and 645 at 2-years. Mean declines at 2-years across all patients were -1.9, -4.8, -4.9, and -13.3 points for urinary obstructive, urinary incontinence, bowel, and sexual symptom domains, respectively, corresponding to MCD in 29%, 20%, and 28% of patients. On multivariate analysis (vs. IMRT), brachytherapy had worse urinary irritation at 2-years (-6.8 points, p < 0.0001) but no differences in other domains (p > 0.15). QOL after SBRT was similar for urinary (p > 0.5) and sexual domains (p = 0.57), but was associated with better bowel score (+6.7 points, p < 0.0002). Conclusions QOL 2-years after brachytherapy, IMRT, or SBRT is very good and largely similar, with small differences in urinary and bowel QOL that are likely minimized by modern techniques.
AB - Background and purpose Stereotactic body radiotherapy (SBRT) is being used for prostate cancer, but concerns persist about toxicity compared to other radiotherapy options. Materials and methods We conducted a multi-institutional pooled cohort analysis of patient-reported quality of life (QOL) [EPIC-26] before and after intensity-modulated radiotherapy (IMRT), brachytherapy, or SBRT for localized prostate cancer. Data were analyzed by mean domain score, minimal clinically detectable difference (MCD) in domain score, and multivariate analyses to determine factors associated with domain scores at 2-years. Results Data were analyzed from 803 patients at baseline and 645 at 2-years. Mean declines at 2-years across all patients were -1.9, -4.8, -4.9, and -13.3 points for urinary obstructive, urinary incontinence, bowel, and sexual symptom domains, respectively, corresponding to MCD in 29%, 20%, and 28% of patients. On multivariate analysis (vs. IMRT), brachytherapy had worse urinary irritation at 2-years (-6.8 points, p < 0.0001) but no differences in other domains (p > 0.15). QOL after SBRT was similar for urinary (p > 0.5) and sexual domains (p = 0.57), but was associated with better bowel score (+6.7 points, p < 0.0002). Conclusions QOL 2-years after brachytherapy, IMRT, or SBRT is very good and largely similar, with small differences in urinary and bowel QOL that are likely minimized by modern techniques.
KW - Brachytherapy
KW - IMRT
KW - Prostate cancer
KW - Quality of life
KW - Stereotactic body radiotherapy (SBRT)
UR - http://www.scopus.com/inward/record.url?scp=84953840072&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2015.07.016
DO - 10.1016/j.radonc.2015.07.016
M3 - Article
C2 - 26276528
AN - SCOPUS:84953840072
SN - 0167-8140
VL - 116
SP - 179
EP - 184
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 2
ER -