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Clinical and Translational Oncology

, Volume 11, Issue 7, pp 470–478 | Cite as

Quality of life two years after radical prostatectomy, prostate brachytherapy or external beam radiotherapy for clinically localised prostate cancer: the Catalan Institute of Oncology/Bellvitge Hospital experience

  • Ferran Guedea
  • Montserrat Ferrer
  • Joan Pera
  • Ferrán Aguiló
  • Anna Boladeras
  • José Francisco Suárez
  • Oriol Cunillera
  • Ferrán Ferrer
  • Yolanda Pardo
  • Evelyn Martínez
  • Montse Ventura
  • the Multicentric Spanish Group of Localized Prostate Cancers
Research Articles
First Online:

Abstract

Objective

The objective was to compare the short- and long-term impact of 3 different treatment modalities on health-related quality of life (HRQOL) in patients treated for localised prostate cancer at a single centre in Catalonia, Spain.

Material and methods

This was a longitudinal, prospective study of 304 patients from a single centre in Catalonia, Spain. Patients underwent 1 of 3 treatment procedures: radical prostatectomy (114 patients), external beam radiation (134) or interstitial brachytherapy (56). HRQOL was assessed by both general and specific questionnaires, including the SF-36 health survey and the Expanded Prostate Cancer Index Composite (EPIC). Interviews were administered prior to treatment and at months 1, 3, 6, 12 and 24. One-way analysis of variance and generalised estimating equations models were constructed to assess between-group differences in HRQOL.

Results

After initial deterioration, HRQOL scores partially recovered, although significant differences between treatment groups persisted at two years. Worsening of urinary incontinence was especially marked for the radical prostatectomy group (11.45, p=0.005), while deterioration in the urinary irritative/obstructive domain was worse following brachytherapy treatment (4.76, p=0.025). Decline in sexual function was significantly greater for the radical prostatectomy group than for the brachytherapy group (18.74, p<0.001). No significant between-group differences were observed in bowel domain scores.

Conclusions

Quality of life 2 years after treatment for prostate cancer shows wide variability. Radical prostatectomy had the largest negative impact on the sexual and urinary incontinence domains. Differences between external radiation and brachytherapy were relatively small. Brachytherapy led to a moderate increase in urinary irritation compared to the other 2 groups.

Keywords

HRQOL Quality of life Brachytherapy Radiotherapy Prostatectomy Prostate cancer 
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References

  1. 1.
    Heidenreich A, Aus G, Bolla M et al (2008) EAU guidelines on prostate cancer. Eur Urol 53:68–80PubMedCrossRefGoogle Scholar
  2. 2.
    Albertsen PC, Hanley JA, Fine J (2005) 20-year outcomes following conservative management of clinically localized prostate cancer. JAMA 293:2095–2101PubMedCrossRefGoogle Scholar
  3. 3.
    Draisma G, Boer R, Otto SJ et al (2003) Lead times and overdetection due to prostate-specific antigen screening: estimates from the European Randomized Study of Screening for Prostate Cancer. J Natl Cancer Inst 95:868–878PubMedCrossRefGoogle Scholar
  4. 4.
    Peschel RE, Colberg JW (2003) Surgery, brachytherapy, and external-beam radiotherapy for early prostate cancer. Lancet Oncol 4:233–241PubMedCrossRefGoogle Scholar
  5. 5.
    Chun FK, Graefen M, Zacharias M et al (2006) Anatomic radical retropubic prostatectomy-longterm recurrence-free survival rates for localized prostate cancer. World J Urol 24:273–280PubMedCrossRefGoogle Scholar
  6. 6.
    Bernier J, Hall EJ, Giaccia A (2004) Radiation oncology: a century of achievements. Nat Rev Cancer 4:737–747PubMedCrossRefGoogle Scholar
  7. 7.
    D’Amico AV, Whittington R, Malkowicz SB et al (1998) Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 280:969–974PubMedCrossRefGoogle Scholar
  8. 8.
    Kupelian PA, Potters L, Khuntia D et al (2004) Radical prostatectomy, external beam radiotherapy <72 Gy, external beam radiotherapy > or =72 Gy, permanent seed implantation, or combined seeds/external beam radiotherapy for stage T1–T2 prostate cancer. Int J Radiat Oncol Biol Phys 58:25–33PubMedCrossRefGoogle Scholar
  9. 9.
    Potters L, Klein EA, Kattan MW et al (2004) Monotherapy for stage T1–T2 prostate cancer: radical prostatectomy, external beam radiotherapy, or permanent seed implantation. Radiother Oncol 71:29–33PubMedCrossRefGoogle Scholar
  10. 10.
    Walz C, Joniau S, Salem N et al (2008) A matchedpair analysis between radical prostatectomy and low dose rate brachytherapy in low risk prostate cancer patients. Eur Urol Suppl 7:167 [Abstract]CrossRefGoogle Scholar
  11. 11.
    Bacon CG, Giovannucci E, Testa M, Kawachi I (2001) The impact of cancer treatment on quality of life outcomes for patients with localized prostate cancer. J Urol 166:1804–1810PubMedCrossRefGoogle Scholar
  12. 12.
    Brandeis JM, Litwin MS, Burnison CM, Reiter RE (2000) Quality of life outcomes after brachytherapy for early stage prostate cancer. J Urol 163:851–857PubMedCrossRefGoogle Scholar
  13. 13.
    Burnett AL, Aus G, Canby-Hagino ED et al (2007) Erectile function outcome reporting after clinically localized prostate cancer treatment. J Urol 178:597–601PubMedCrossRefGoogle Scholar
  14. 14.
    Buron C, Le Vu B, Cosset JM et al (2007) Brachytherapy versus prostatectomy in localized prostate cancer: results of a French multicenter prospective medico-economic study. Int J Radiat Oncol Biol Phys 67:812–822PubMedGoogle Scholar
  15. 15.
    Dandapani SV, Sanda MG (2008) Measuring health-related quality of life consequences from primary treatment for early-stage prostate cancer. Semin Radiat Oncol 18:67–72PubMedCrossRefGoogle Scholar
  16. 16.
    Davis JW, Kuban DA, Lynch DF, Schellhammer PF (2001) Quality of life after treatment for localized prostate cancer: differences based on treatment modality. J Urol 166:947–952PubMedCrossRefGoogle Scholar
  17. 17.
    Ferrer M, Suarez JF, Guedea F et al (2008) Healthrelated quality of life 2 years after treatment with radical prostatectomy, prostate brachytherapy, or external beam radiotherapy in patients with clinically localized prostate cancer. Int J Radiat Oncol Biol Phys 72:421–432PubMedGoogle Scholar
  18. 18.
    Frank SJ, Pisters LL, Davis J et al (2007) An assessment of quality of life following radical prostatectomy, high dose external beam radiation therapy and brachytherapy iodine implantation as monotherapies for localized prostate cancer. J Urol 177:2151–2156PubMedCrossRefGoogle Scholar
  19. 19.
    McCammon KA, Kolm P, Main B, Schellhammer PF (1999) Comparative quality-of-life analysis after radical prostatectomy or external beam radiation for localized prostate cancer. Urology 54:509–516PubMedCrossRefGoogle Scholar
  20. 20.
    Mols F, van de Poll-Franse LV, Vingerhoets AJ et al (2006) Long-term quality of life among Dutch prostate cancer survivors: results of a populationbased study. Cancer 107:2186–2196PubMedCrossRefGoogle Scholar
  21. 21.
    Namiki S, Satoh T, Baba S et al (2006) Quality of life after brachytherapy or radical prostatectomy for localized prostate cancer: a prospective longitudinal study. Urology 68:1230–1236PubMedCrossRefGoogle Scholar
  22. 22.
    Newton F, Millar JL, Burney S et al (2008) Characterization of the pattern of sexual function after brachytherapy or radical prostatectomy suggests the importance of expectation management. Brachytherapy 7:121 [Abstract]CrossRefGoogle Scholar
  23. 23.
    Pinkawa M, Fischedick K, Piroth MD et al (2006) Health-related quality of life after permanent interstitial brachytherapy for prostate cancer: correlation with postimplant CT scan parameters. Strahlenther Onkol 182:660–665PubMedCrossRefGoogle Scholar
  24. 24.
    Saito S, Nagata H, Kosugi M et al (2008) Comparison of health related quality of life after the treatment of prostate cancer with permanent seed implantation brachytherapy and radical prostatectomy. Brachytherapy 7:121 [Abstract]CrossRefGoogle Scholar
  25. 25.
    Sanda MG, Dunn RL, Michalski J et al (2008) Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med 358:1250–1261PubMedCrossRefGoogle Scholar
  26. 26.
    Suarez JF, Aguilo F, Ferrer M et al (2007) Impact on health-related quality of life of radical prostatectomy and prostate brachytherapy in patients with low and intermediate-risk clinically localized prostate cancer. Eur Urol Suppl 6:54 [Abstract]CrossRefGoogle Scholar
  27. 27.
    Tepera C, Berry T, Schellhammer P et al (2008) Prospective, longitudinal, ongoing study of health related quality of life (QOL) in patients undergoing cryoablation as compared to brachytherapy for localized prostate cancer. J Urol 179:398 [Abstract]CrossRefGoogle Scholar
  28. 28.
    Yoshimura K, Kamoto T, Nakamura E et al (2007) Health-related quality-of-life after external beam radiation therapy for localized prostate cancer: intensity-modulated radiation therapy versus conformal radiation therapy. Prostate Cancer Prostatic Dis 10:288–292PubMedCrossRefGoogle Scholar
  29. 29.
    Bice WS Jr, Prestidge BR, Prete JJ, Dubois DF (1998) Clinical impact of implementing the recommendations of AAPM Task Group 43 on permanent prostate brachytherapy using 125I. American Association of Physicists in Medicine. Int J Radiat Oncol Biol Phys 40:1237–1241Google Scholar
  30. 30.
    Ware JE, Kosinski M, Dewey JE (2000) How to Score. Version 2 of the SF-36 Health Survey (Standard & Acute Forms). Quality Metric Incorporated, Lincoln, RIGoogle Scholar
  31. 31.
    Wei JT, Dunn RL, Litwin MS et al (2000) Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology 56:899–905PubMedCrossRefGoogle Scholar
  32. 32.
    Schostak M, Miller K, Schrader M (2008) Radical prostatectomy in the 21st century — the gold standard for localized and locally advanced prostate cancer. Front Radiat Ther Oncol 41:7–14PubMedCrossRefGoogle Scholar
  33. 33.
    Block T, Czempiel H, Zimmermann F (2006) Transperineal permanent seed implantation of “low-risk” prostate cancer: 5-year-experiences in 118 patients. Strahlenther Onkol 182:666–671PubMedCrossRefGoogle Scholar
  34. 34.
    Machtens S, Baumann R, Hagemann J et al (2006) Long-term results of interstitial brachytherapy (LDR-Brachytherapy) in the treatment of patients with prostate cancer. World J Urol 24:289–295PubMedCrossRefGoogle Scholar
  35. 35.
    Stock RG, Cesaretti JA, Stone NN (2006) Disease-specific survival following the brachytherapy management of prostate cancer. Int J Radiat Oncol Biol Phys 64:810–816PubMedGoogle Scholar
  36. 36.
    Trojan L, Harrer K, Bolenz C et al (2008) Longterm functional outcome after treatment of prostate cancer: radical prostatectomy vs. brachytherapy. Eur Urol Suppl 7:168 [Abstract]CrossRefGoogle Scholar
  37. 37.
    Borchers H, Kirschner-Hermanns R, Brehmer B et al (2004) Permanent 125I-seed brachytherapy or radical prostatectomy: a prospective comparison considering oncological and quality of life results. BJU Int 94:805–811PubMedCrossRefGoogle Scholar
  38. 38.
    Litwin MS, Gore JL, Kwan L et al (2007) Quality of life after surgery, external beam irradiation, or brachytherapy for early-stage prostate cancer. Cancer 109:2239–2247PubMedCrossRefGoogle Scholar

Copyright information

© Feseo 2009

Authors and Affiliations

  • Ferran Guedea
    • 1
  • Montserrat Ferrer
    • 3
  • Joan Pera
    • 1
  • Ferrán Aguiló
    • 2
  • Anna Boladeras
    • 1
  • José Francisco Suárez
    • 2
  • Oriol Cunillera
    • 3
  • Ferrán Ferrer
    • 1
  • Yolanda Pardo
    • 3
  • Evelyn Martínez
    • 1
  • Montse Ventura
    • 1
  • the Multicentric Spanish Group of Localized Prostate Cancers
  1. 1.Catalan Institute of OncologyL’Hospitalet de LlobregatBarcelonaSpain
  2. 2.Hospital Universitari de BellvitgeBarcelonaSpain
  3. 3.Unidad de Investigación en Servicios SanitariosIMIM-Hospital del MarBarcelonaSpain

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