Health-Related Quality of Life in Patients With Locally Advanced Prostate Cancer After 76 Gy Intensity-Modulated Radiotherapy vs. 70 Gy Conformal Radiotherapy in a Prospective and Longitudinal Study

• Published in: International journal of radiation oncology, biology, physics Vol. 69; no. 3; pp. 656 - 661
• Main Authors: Lips, Irene, M.D, Dehnad, Human, M.D, Kruger, Arto Boeken, M.D, van Moorselaar, Jeroen, M.D., Ph.D, van der Heide, Uulke, Ph.D, Battermann, Jan, M.D., Ph.D, van Vulpen, Marco, M.D., Ph.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2007
• Subjects: Aged; CARCINOMAS; COMPARATIVE EVALUATIONS; Dose escalation; Health Status; Hematology, Oncology and Palliative Medicine; Humans; Hyperthermia, Induced; Intensity-modulated radiotherapy (IMRT); Longitudinal Studies; Male; Middle Aged; PAIN; PATIENTS; Position verification; Prospective Studies; PROSTATE; Prostate cancer; Prostatic Neoplasms - pathology; Prostatic Neoplasms - radiotherapy; Prostheses and Implants; Quality of Life; Quality of life (QoL); RADIATION DOSES; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; RADIOTHERAPY; Radiotherapy Dosage; Radiotherapy, Conformal - adverse effects; Radiotherapy, Conformal - methods; Radiotherapy, Intensity-Modulated - adverse effects; Radiotherapy, Intensity-Modulated - methods; VERIFICATION; Quality of life (QoL); Position verification; Dose escalation; Intensity-modulated radiotherapy (IMRT); Prostate cancer
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/j.ijrobp.2007.04.013

Purpose To compare quality of life (QoL) after 70 Gy conformal radiotherapy with QoL after 76 Gy intensity-modulated radiotherapy (IMRT) in patients with locally advanced prostate carcinoma. Methods and Materials Seventy-eight patients with locally advanced prostate cancer were treated with 70 Gy three-field conformal radiotherapy, and 92 patients received 76 Gy IMRT with fiducial markers for position verification. Quality of life was measured by RAND-36, the European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30(+3)), and the prostate-specific EORTC QLQ-PR25, before radiotherapy (baseline) and 1 month and 6 months after treatment. Quality of life changes in time (baseline vs. 1 month and baseline vs. 6 months) of ≥10 points were considered clinically relevant. Results Differences between the treatment groups for QoL changes over time occurred in several QoL domains. The 76-Gy group revealed no significant deterioration in QoL compared with the 70-Gy group. The IMRT 76-Gy group even demonstrated a significantly better change in QoL from baseline to 1 month in several domains. The conformal 70-Gy group revealed temporary deterioration in pain , role functioning , and urinary symptoms ; for the IMRT 76-Gy group a better QoL in terms of change in health existed after 1 month, which persisted after 6 months. For both treatment groups temporary deterioration in physical role restriction occurred after 1 month, and an improvement in emotional role restriction occurred after 6 months. Sexual activity was reduced after treatment for both groups and remained decreased after 6 months. Conclusions Intensity-modulated radiotherapy and accurate position verification seem to provide a possibility to increase the radiation dose for prostate cancer without deterioration in QoL.