KEY TAKEAWAYS
- The study investigated the impact of post-radical prostatectomy external beam radiation therapy on health-related quality of life in prostate cancer patients.
- The participants were divided into three groups: those who underwent RP only, those who received early XRT after RP (within ≤12 months), and those who received late XRT after RP (>12 months).
- The study found that individuals who received post-RP XRT experienced significant negative changes in their HRQOL compared to those who underwent RP alone.
In the PROST-QA (2003-2006) and RP2 (2010-2014) studies,1,203 men with localized prostate cancer underwent radical prostatectomy (RP), and within this cohort, 121 men underwent post-RP XRT. All participants were enrolled prospectively and underwent ongoing clinical follow-up and third-party evaluation of their health-related quality of life (HRQOL). The main focus of the investigation was the receipt and timing of post-RP XRT, leading to the formation of three distinct treatment groups: 1) RP only (n=1,082), 2) RP followed by early XRT (n=57), and 3) RP followed by late XRT (n=64).
The distinction between early and late XRT was established as XRT administered within ≤12 months and >12 mo after the radical prostatectomy (RP), respectively. The primary result was HRQOL employing the Expanded Prostate Cancer Index Composite (EPIC-26) scores, the domains of sexual function, urinary incontinence, and irritation/obstruction, measured both prior to treatment and annually thereafter. To compare the treatment groups, statistical analysis employed multivariable generalized estimating equations (GEE) models to analyze changes in longitudinal HRQOL domain scores. Changes in urinary incontinence pad usage were examined before and after post-RP XRT.
The median follow-up for the entire group was 85.6 months (with an interquartile range (IQR) of 35.8-117.2). In comparison to individuals who underwent radical prostatectomy (RP) alone, those who received post-RP XRT experienced significant adverse changes in HRQOL (p-values of 0.03, 0.004, and <0.001). Identifying HRQOL distinctions between early and late post-RP XRT was challenging, potentially due to the size of the XRT groups (total n=121). After early XRT, improvement in post-RP recovery for urinary control was observed, evidenced by the fact that 49% of participants were pad-free before XRT, and this number increased to 70% during their subsequent HRQOL assessments.
This prospective cohort study, accompanied by an extended follow-up period, substantiated the adverse effect of XRT on the health-related quality of life (HRQOL) following radical prostatectomy (RP). The ability to distinguish between late and early XRT after RP was not feasible due to the size of post-RP XRT groups. Additional investigation is required to evaluate the distinct influence of treatments and the progression/recurrence of prostate cancer on HRQOL.
Source: https://www.auajournals.org/doi/10.1097/JU.0000000000003262.02
Clinical Trial: https://classic.clinicaltrials.gov/ct2/show/NCT01325506
Olsen, T. Anders; Patel, Sagar; Patil, Dattatraya; Alperti, Louis; Smith, Joseph; Saigal, Christopher; Litwin, Mark; Hu, Jim; Cooperberg, Matthew; Carroll, Peter; Klein, Eric; Ciezki, Jay; Kibel, Adam; Andriole, Gerald; Michalski, Jeff; Han, Misop; Partin, Alan; Wood, David; Hembroff, Larry; Spratt, Daniel; Wei, John; Sandler, Howard; Hamstra, Daniel; Pisters, Louis; Kuban, Deborah; Regan, Meredith; Wagner, Andrew; Kaplan, Irving; Crociani, Catrina; Sanda, Martin; Chang, Peter PD15-02 LONG-TERM HEALTH RELATED QUALITY OF LIFE IN PROSTATE CANCER PATIENTS REQUIRING RADIOTHERAPY AFTER RADICAL PROSTATECTOMY, Journal of Urology: April 2023 – Volume 209 – Issue Supplement 4 doi: 10.1097/JU.0000000000003262.02
