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

Details

• Alternative Title:
  J Urol
• Personal Author:
  De, Brian ; Pasalic, Dario ; Barocas, Daniel A. ; Wallis, Christopher J.D. ; Huang, Li-Ching ; Zhao, Zhiguo ; Koyama, Tatsuki ; Tang, Chad ; Conwill, Ralph ; Goodman, Michael ; Hamilton, Ann S. ; Wu, Xiao-Cheng ; Paddock, Lisa E. ; Stroup, Antoinette ; Cooperberg, Matthew R. ; Hashibe, Mia ; O’Neil, Brock B. ; Kaplan, Sherrie H. ; Greenfield, Sheldon ; Penson, David F. ; Hoffman, Karen E.
• 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.
  
  
• Subjects:
  Brachytherapy Humans Male Patient Reported Outcome Measures Prospective Studies Prostate Prostatectomy Prostatic Neoplasms Quality Of Life Urinary Incontinence
• Keywords:
  Alzheimer's Disease Alzheimer's Disease Sequencing Project Antiviral Agents Herpes Simplex Human Papillomavirus Low Dose Rate Brachytherapy Patient Reported Outcome Measures Radical Prostatectomy Torque Teno Viruses Whole Exome Sequencing Whole Genome Sequencing

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• Source:
  J Urol. 208(6):1226-1239
• Pubmed ID:
  36006050
• Pubmed Central ID:
  PMC9933910
• Document Type:
  Journal Article
• Funding:
  P30 CA016672/CA/NCI NIH HHSUnited States/ ; NU58DP006320/CC/CDC HHSUnited States/ ; HHSN261201800016C/CA/NCI NIH HHSUnited States/ ; HHSN261201800016I/CA/NCI NIH HHSUnited States/ ; R01 CA230352/CA/NCI NIH HHSUnited States/ ; R01 HS022640/HS/AHRQ HHSUnited States/ ; UL1 TR000445/TR/NCATS NIH HHSUnited States/ ; R01 HS019356/HS/AHRQ HHSUnited States/
• Volume:
  208
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:29d871ddbf577422d00e5f36951a5c0d374e6a7c11b1cb0bab7f97daf1687e254b993cef9ed5d90bd697c28f4106977ebc7b9894133b808cdc2af1d15af404cf
• Download URL:
  https://stacks.cdc.gov/view/cdc/124824/cdc_124824_DS1.pdf
• File Type:
  [PDF - 1014.57 KB ]