Long-term Quality of Life in Prostate Cancer Patients Treated with Cesium-131

• Published in: International journal of radiation oncology, biology, physics Vol. 98; no. 5; pp. 1053 - 1058
• Main Authors: Glaser, Scott M., MD, Chen, Katherine S., BS, Benoit, Ronald M., MD, Smith, Ryan P., MD, Beriwal, Sushil, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2017
• Subjects: Aged; BRACHYTHERAPY; Brachytherapy - methods; CESIUM 131; Cesium Radioisotopes - therapeutic use; EXTERNAL BEAM RADIATION THERAPY; Follow-Up Studies; Hematology, Oncology and Palliative Medicine; Humans; Male; Middle Aged; NEOPLASMS; PATIENTS; PROSTATE; Prostatic Neoplasms - radiotherapy; QUALITY OF LIFE; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Statistics, Nonparametric; Surveys and Questionnaires; Time Factors; Cesium-131; Quality of Life; Bowel Toxicity; Brachytherapy; Prostate Cancer; Urinary Toxicity
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/j.ijrobp.2017.03.046

Abstract Purpose Prostate brachytherapy as monotherapy or in combination with external beam radiation therapy (EBRT) represents a curative treatment option for men with prostate cancer. Of the radioactive isotopes approved for use in prostate brachytherapy, Cesium-131 (Cs-131) is the newest to market and has the shortest half-life. This property may impact resolution of acute voiding toxicities associated with brachytherapy. The aim of this study is to evaluate long-term patient-reported quality of life (QOL) scores in men treated at our institution with Cs-131 prostate brachytherapy. Materials and Methods Patients treated greater than 4 years ago with Cs-131 (n=290) were asked to fill out an Expanded Prostate Cancer Index Composite (EPIC) QOL questionnaire and American Urological Association Symptom Score (AUASS) survey, before treatment and at each follow-up appointment. We compared patients’ EPIC and AUA scores at baseline to scores at a last follow-up of at least 4 years post-treatment using the Wilcoxon signed-rank test. Results At a median last follow-up of 5.5 years post-treatment with Cs-131 prostate brachytherapy, there were no clinically significant changes in the EPIC or AUA scores from baseline. There was statistical worsening in the EPIC urinary incontinence subscore. Subset analyses revealed improved QOL outcomes in patients who received EBRT or alpha-blocker therapy (ABT), while androgen deprivation therapy (ADT) was not associated with differences in QOL change. Conclusions Our results demonstrate minimal long-term changes in urinary or bowel patient reported quality of life with Cs-131 prostate brachytherapy. These findings suggest that patients treated with this isotope are able to recover and then maintain their baseline quality of life in the long term.