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

Authors

  • Marie Hjälm-Eriksson Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden;Department of Surgery, Capio S:t Göran’s Hospital, Stockholm, Sweden
  • Anders Ullén Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Pelvic cancer, Genitourinary oncology and urology unit, Karolinska University Hospital, Stockholm, Sweden
  • Sten Nilsson Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
  • Hemming Johansson Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
  • Josef Nilsson Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
  • Enrique Castellanos Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Pelvic cancer, Genitourinary oncology and urology unit, Karolinska University Hospital, Stockholm, Sweden
  • Yvonne Brandberg Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Pelvic cancer, Genitourinary oncology and urology unit, Karolinska University Hospital, Stockholm, Sweden

DOI:

https://doi.org/10.1080/0284186X.2022.2115314

Keywords:

Prostate cancer, external beam radiotherapy, HDR brachytherapy, long-term HRQoL

Abstract

Background and purpose

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.

Methods and material

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.

Results

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.

Conclusion

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.

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Published

2022-10-03

How to Cite

Hjälm-Eriksson, M., Ullén, A., Nilsson, S., Johansson, H., Nilsson, J., Castellanos, E., & Brandberg, Y. (2022). High levels of health-related quality of life five years after curative treatment of prostate cancer with HDR-brachytherapy and external beam radiation. Acta Oncologica, 61(10), 1179–1185. https://doi.org/10.1080/0284186X.2022.2115314