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Patient-Reported Outcomes after External Beam Radiotherapy with Low Dose-Rate Brachytherapy Boost versus Radical Prostatectomy for Localized Prostate Cancer: Five-Year Results from a Prospective Comparative Effectiveness Study
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12 2022
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Source: J Urol. 208(6):1226-1239
[PDF-1014.57 KB]
Details:
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Alternative Title:J Urol
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Personal Author:
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Description:Background:
Data comparing radical prostatectomy (RP) and external beam radiation therapy with low-dose rate brachytherapy boost (EBRT-LDR) are lacking. To better guide shared decision-making regarding treatment, we compared patient reported outcomes (PROs) through 5 years following RP or EBRT-LDR for localized prostate cancer.
Methods:
From 2011–2012, men aged < 80 years with localized prostate adenocarcinoma were enrolled and followed longitudinally. PROs included the Expanded Prostate Index Composite. Regression models adjusted for baseline scores and covariates were constructed.
Results:
The study population included 112 men treated with EBRT-LDR and 1553 treated with RP. Compared to RP, EBRT-LDR was associated with clinically meaningful worse urinary irritative/obstructive (adjusted mean score difference [95% confidence interval]: −5.0 [−8.7, −1.3]; P=0.008 at 5 years) and better urinary incontinence function (13.3 [7.7, 18.9]; P<0.001 at 5 years) through 5 years. Urinary function bother was similar between groups (P>0.4 at all timepoints). Treatment with EBRT-LDR was associated with worse bowel function (−4.0 [−6.9, −1.1]; P=0.006 at 5 years) through 5 years compared to RP. Treatment with EBRT-LDR was associated with better sexual function at 1 year (12.0 [6.5, 17.5]; P<0.001 at 1 year) compared to RP, but there was insufficient evidence to reject the supposition that no difference was seen at 3 or 5 years.
Conclusion:
Compared to RP, EBRT-LDR was associated with clinically meaningful worse urinary irritative/obstructive and bowel functions but better urinary incontinence function through 5 years after treatment. These patient-reported functional outcomes may clarify treatment expectations and help inform treatment choices for localized prostate cancer.
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Pubmed ID:36006050
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Pubmed Central ID:PMC9933910
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Volume:208
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Issue:6
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