1. A prospective analysis of health-related quality of life in intermediate and high-risk prostate cancer patients managed with intensity modulated radiation therapy, with vs. without hormonal therapy.
- Author
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Caumont F, Conti G, Hurwitz LM, Kuo C, Levie KE, Badiozamani K, Frankel JK, Flores JP, Brand TC, Chaurasia A, Rosner IL, Stroup SP, Musser JE, Cullen J, and Porter CR
- Subjects
- Aged, Androgen Antagonists adverse effects, Chemoradiotherapy methods, Defecation drug effects, Defecation radiation effects, Follow-Up Studies, Humans, Linear Models, Longitudinal Studies, Male, Middle Aged, Models, Psychological, Prospective Studies, Prostatic Neoplasms diagnosis, Prostatic Neoplasms mortality, Prostatic Neoplasms psychology, Radiotherapy, Intensity-Modulated methods, Risk Assessment statistics & numerical data, Risk Factors, Self Report statistics & numerical data, Sexual Behavior drug effects, Sexual Behavior psychology, Sexual Behavior radiation effects, Treatment Outcome, Urination drug effects, Urination radiation effects, Antineoplastic Agents, Hormonal adverse effects, Chemoradiotherapy adverse effects, Prostatic Neoplasms therapy, Quality of Life, Radiotherapy, Intensity-Modulated adverse effects
- Abstract
Introduction: Combined radiotherapy and hormonal treatment are recommended for intermediate- and high-risk prostate cancer (CaP). This study compared the long-term effects on health-related quality of life (HRQoL) of intermediate- and high-risk CaP patients managed with radiation therapy (RT) with vs. without hormone therapy (HT)., Methods: Patients with intermediate- and high-risk CaP enrolled in the Center for Prostate Disease Research diagnosed from 2007 to 2017 were included. EPIC and SF-36 questionnaires were completed and HRQoL scores were compared for patients receiving RT vs. RT + HT at baseline (pretreatment), 6, 12, 24, 36, 48, and 60 months after CaP diagnosis. Longitudinal patterns of change in HRQoL were modeled using linear regression models, adjusting for baseline HRQoL, age at CaP diagnosis, race, comorbidities, National Comprehensive Cancer Network (NCCN) risk stratum, time to treatment, and follow-up time., Results: Of 164 patients, 93 (56.7%) received RT alone and 71 (43.3%) received RT + HT. Both groups reported comparable baseline HRQoL. Patients receiving RT+HT were more likely to be NCCN high risk as compared to those receiving only RT. The RT + HT patients experienced worse sexual function, hormonal function, and hormonal bother than those who only received RT; however, HRQoL recovered over time for the RT + HT group. No significant differences were observed between groups in urinary and bowel domains or SF-36 mental and physical scores., Conclusion: Combined RT + HT treatment was associated with temporary lower scores in sexual and hormonal HRQoL compared with RT only. Intermediate- and high-risk CaP patients should be counseled about the possible declines in HRQoL associated with HT., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2020
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