SBRT, HDR brachytherapy improve quality of life in prostate cancer

Stereotactic body radiation therapy (SBRT) and high dose rate (HDR) brachytherapy improve urinary patient-reported quality of life (PRQOL) compared with the low dose rate (LDR) in a cohort of prostate cancer patients treated with modern radiotherapy techniques, a study has shown.

The investigators prospectively collected International Prostate Symptom Score (IPSS), Sexual Health Inventory for Men (SHIM), and Expanded Prostate cancer Index Composite Short Form (EPIC-26) for men with low/intermediate-risk cancer treated at a single institution.

Generalized Estimating Equations were used to identify association between variables and early (3 to 6 mo) or late (1 to 2 years) PRQOL scores. Minimally important differences (MID) were compared to assess clinical relevance.

From 2001 to 2018, a total of 342 LDR, 159 HDR, and 112 SBRT patients were treated and eligible for this study. Gleason score, prostate-specific antigen, and age were lower among LDR than HDR and SBRT patients.

Unadjusted baseline IPSS was comparable in all groups. Compared with baseline, adjusted IPSS worsened at all time points after LDR or HDR. The rates of IPSS MID after LDR were higher than those of HDR or SBRT at early/late time points. No IPSS differences were observed between HDR and SBRT.

Early and late SHIM worsening occurred in all treatment modalities. No temporal differences were seen in SHIM between SBRT and brachytherapy. There were also no differences noted in EPIC subdomains between HDR and SBRT.

Bowel symptoms got worse early after SBRT, while urinary irritative/obstructive symptoms exacerbated late after HDR. Moreover, MID after SBRT and HDR were similar among all domains.