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Radiother Oncol. 2016 Nov;121(2):294-298. doi: 10.1016/j.radonc.2016.10.013. Epub 2016 Nov 24.

Patient-reported quality of life after stereotactic body radiation therapy versus moderate hypofractionation for clinically localized prostate cancer.

Author information

1
Department of Therapeutic Radiology, Yale School of Medicine, New Haven, United States.
2
Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, United States.
3
21st Century Oncology, Fort Myers, United States.
4
Georgetown University Hospital, Washington, United States.
5
Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, United States.
6
University of California, Los Angeles-David Geffen School of Medicine, United States.
7
Fox Chase Cancer Center, Philadelphia, United States.
8
Department of Radiation Oncology, Miller School of Medicine, University of Miami, United States.
9
McGill University Health Center, Montreal, Canada.
10
Department of Therapeutic Radiology, Yale School of Medicine, New Haven, United States; Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, United States. Electronic address: james.b.yu@yale.edu.

Abstract

BACKGROUND AND PURPOSE:

Evaluate changes in bowel, urinary and sexual patient-reported quality of life following treatment with moderately hypofractionated radiotherapy (<5Gray/fraction) or stereotactic body radiation therapy (SBRT;5-10Gray/fraction) for prostate cancer.

MATERIALS AND METHODS:

In a pooled multi-institutional analysis of men treated with moderate hypofractionation or SBRT, we compared minimally detectable difference in bowel, urinary and sexual quality of life at 1 and 2years using chi-squared analysis and logistic regression.

RESULTS:

378 men received moderate hypofractionation compared to 534 men who received SBRT. After 1year, patients receiving moderate hypofractionation were more likely to experience worsening in bowel symptoms (39.5%) compared to SBRT (32.5%; p=.06), with a larger difference at 2years (37.4% versus 25.3%, p=.002). Similarly, patients receiving moderate fractionation had worsening urinary symptom score compared to patients who underwent SBRT at 1 and 2years (34.7% versus 23.1%, p<.001; and 32.8% versus 14.0%, p<.001). There was no difference in sexual symptom score at 1 or 2years. After adjusting for age and cancer characteristics, patients receiving SBRT were less likely to experience worsening urinary symptom scores at 2years (odds ratio: 0.24[95%CI: 0.07-0.79]).

CONCLUSIONS:

Patients who received SBRT or moderate hypofractionation have similar patient-reported change in bowel and sexual symptoms, although there was worse change in urinary symptoms for patients receiving moderate hypofractionation.

KEYWORDS:

Hypofractionated; Prostate cancer; Quality of life; Radiation; SBRT

PMID:
27890426
DOI:
10.1016/j.radonc.2016.10.013
[Indexed for MEDLINE]

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