High levels of health-related quality of life five years after curative treatment of prostate cancer with HDR-brachytherapy and external beam radiation

• Published in: Acta oncologica 2022-10, Vol.61 (10), p.1179-1185
• Main Authors: Hjälm-Eriksson, Marie, Ullén, Anders, Nilsson, Sten, Johansson, Hemming, Nilsson, Josef, Castellanos, Enrique, Brandberg, Yvonne
• Format: Article
• Language: English
• Subjects: external beam radiotherapy; HDR brachytherapy; long-term HRQoL; Medicin och hälsovetenskap; Prostate cancer
• ISSN: 0284-186X; 1651-226X; 1651-226X
• DOI: 10.1080/0284186X.2022.2115314

The aim of this cross-sectional study was to investigate long-term health-related quality of life (HRQoL) in men with prostate cancer treated 2002-2008 with external beam radiotherapy (EBRT) combined with high dose-rate brachytherapy (HDRBT), Cohort A, and to compare these data with age-adjusted normative data. In addition, differences in HRQoL following adjustments of the brachytherapy technique in 2001 were investigated by comparing Cohort A with men treated at the same clinic from 1998-2000, Cohort B. Cohort A: 1495 men treated with EBRT 2 Gy to 50 Gy and 2 fractions of 10 Gy HDRBT at a single centre, 2002-2008, still alive at five years. As part of routine follow-up, the patients responded to the EORTC QLQ-C30 and PR-25 questionnaires. Cohort B: HRQoL data was retrieved from an earlier study from the original article. In Cohort A, 1046 (70%) men completed the questionnaires at five years, median age 66 years. In general, HRQoL mean scores were high and similar to Swedish age-matched normative data. Concerning disease-specific HRQoL, low levels of bowel and urinary problems were reported, in contrast to a substantial effect on sexual functioning. 'No' or 'A little' problems with faecal incontinence and urinary incontinence were reported by 98% and 93% of patients, respectively. The corresponding figure for sexual functioning was 39%. A difference in the frequency of nocturia in favour of Cohort A was the only statistically significant difference between Cohort A and B found in general and disease-specific HRQOL (p = 0.03), despite modifications in the brachytherapy procedure introduced in 2001. Long-term general HRQoL was rated high and comparable to an aged-matched reference population five years after treatment with combined radiotherapy. Disease-specific HRQoL was still affected, foremost in the sexual domain.