PURPOSE: To determine the impact of late radiation-induced toxicity on health-related quality of life (HRQoL) among patients with prostate cancer.PATIENTS AND METHODS: The study sample was composed of 227 patients, treated with external beam radiotherapy. Common Terminology Criteria for Adverse Events version 3.0 were used to grade late genitourinary and gastrointestinal toxicity. The European Organization for Research and Treatment of Cancer Quality of life Questionnaire C30 (EORTC QLQ-C30) was used to assess HRQoL at baseline, and 6, 12 and 24 months after completion of radiotherapy. Statistical analysis was performed using a multivariate analysis of variance (MANOVA).RESULTS: Urinary incontinence and rectal discomfort significantly affected HRQoL. The impact of urinary incontinence on HRQoL was most pronounced 6 months after radiotherapy and gradually decreased over time. The impact of rectal discomfort on HRQoL was predominant at 6 months after radiotherapy, decreased at 12 months and increased again 2 years after radiotherapy. No significant impact on HRQoL was observed for any of the other toxicity endpoints, or non-toxicity related factors such as hormonal therapy, radiotherapy technique or age.CONCLUSION: Urinary incontinence and rectal discomfort have a significant impact on HRQoL. Prevention of these side effects may likely improve quality of life of prostate cancer patients after completion of treatment.
Abstract gepubliseerd in Elsevier: For patients with intermediate- and high risk prostate cancer, treated with high dose radiotherapy, the CTV generally involves the prostate and (part of) the seminal vesicles (SV) [1,2]. Fiducial markers locate the prostate reliably during radiotherapy [3]. However the SV may move independent from the corpus of the prostate [4–6]. As this should be incorporated in the PTV margin [4,6–8], this may lead to a larger irradiated rectum volume and more gastro-intestinal toxicity [9]. Several studies have shown that rectal and bladder filling are of influence on prostate and SV mobility [10–13]. Using a dietary protocol or applying rectal gas removal could somewhat decrease the prostate and SV mobility [14,15], however, these methods are not very patient friendly. In this study we hypothesize that the vesicles become more rigidly attached to the prostate in case of tumour infiltration. This would imply that in case of extensive infiltration, the prostate and vesicles move as a rigid body and are thus adequately localized by marker-based Image Guided Radiotherapy (IGRT). The aim of this study was to assess the impact of tumour invasion in the SV on their mobility.
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PurposeTo investigate the course of quality of life (QoL) among prostate cancer patients treated with external beam radiotherapy and to compare the results with QoL of a normal age-matched reference population.ConclusionProstate cancer patients experience a small worsening of QoL as compared with baseline and as compared with a normal reference population. As co-morbidity modulates patients’ post-treatment QoL, a proper assessment of co-morbidity should be included in future longitudinal analyses on QoL.
