Comparing bowel and urinary domains of patient‐reported quality of life at the end of and 3 months post radiotherapy between intensity‐modulated radiotherapy and proton beam therapy for clinically localized prostate cancer

• Published in: Cancer medicine (Malden, MA) Vol. 9; no. 21; pp. 7925 - 7934
• Main Authors: Bai, Miao, Gergelis, Kimberly R., Sir, Mustafa, Whitaker, Thomas J., Routman, David M., Stish, Bradley J., Davis, Brian J., Pisansky, Thomas M., Choo, Richard
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.11.2020; John Wiley and Sons Inc; Wiley
• Subjects: Bladder; Cancer therapies; Clinical Cancer Research; EPIC‐26; Generalized linear models; Hydrogels; intensity modulated radiotherapy; Intestine; Original Research; Patients; Prostate cancer; proton beam radiotherapy; Quality of life; Questionnaires; Radiation therapy; Urinary incontinence; EPIC-26; prostate cancer; intensity modulated radiotherapy; quality of life; proton beam radiotherapy
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.3414

Purpose To prospectively assess acute differences in patient‐reported outcomes in bowel and urinary domains between intensity‐modulated radiotherapy (IMRT) and proton beam therapy (PBT) for prostate cancer. Methods and Materials Bowel function (BF), urinary irritative/obstructive symptoms (UO), and urinary incontinence (UI) domains of EPIC‐26 were collected in patients with T1‐T2 prostate cancer receiving IMRT or PBT at a tertiary cancer center (2015‐2018). Mean changes in domain scores were analyzed from pretreatment to the end of and 3 months post‐radiotherapy for each modality. A clinically meaningful change was defined as a score change >50% of the baseline standard deviation. Results A total of 157 patients receiving IMRT and 105 receiving PBT were included. There were no baseline differences in domain scores between cohorts. At the end of radiotherapy, there was significant and clinically meaningful worsening of BF and UO scores for patients receiving either modality. In the BF domain, the IMRT cohort experienced greater decrement (−13.0 vs −6.7, P < .01), and had a higher proportion of patients with clinically meaningful reduction (58.4% vs 39.5%, P = .01), compared to PBT. At 3 months post‐radiotherapy, the IMRT group had significant and clinically meaningful worsening of BF (−9.3, P < .001), whereas the change in BF score of the PBT cohort was no longer significant or clinically meaningful (−1.2, P = .25). There were no significant or clinically meaningful changes in UO or UI 3 months post‐radiotherapy. Conclusions PBT had less acute decrement in BF than IMRT following radiotherapy. There was no difference between the two modalities in UO and UI. Prospectively‐collected EPIC‐26 scores were analyzed to assess differences in patient‐reported outcomes in bowel and urinary domains between patients treated with intensity‐modulated radiotherapy (IMRT) and proton beam therapy (PBT) for localized prostate cancer at the end of and 3 months post‐radiotherapy at a tertiary cancer center. Patients treated with PBT had less acute decrement in the bowel function domain than those treated with IMRT; there was no difference between the two modalities in the urinary irritative/obstructive and urinary incontinence (UI) domains.