Patient-reported quality of life during definitive and post-prostatectomy image-guided radiation therapy for prostate cancer

Publication date: Available online 12 August 2016
Source:Practical Radiation Oncology
Author(s): Kevin Diao, Emily A. Lobos, Eda Yirmibesoglu, Ram Basak, Laura H. Hendrix, Brittney Barbosa, Seth M. Miller, Kevin A. Pearlstein, Gregg H. Goldin, Andrew Z. Wang, Ronald C. Chen
PurposeThe importance of patient-reported outcomes is well-recognized. Long-term patient-reported symptoms have been described for individuals who completed radiation therapy (RT) for prostate cancer. However, the trajectory of symptom development during the course of treatment has not been well-described in patients receiving modern, image-guided RT.Methods and MaterialsQuality of life data were prospectively collected for 111 prostate cancer patients undergoing radiotherapy using the validated Prostate Cancer Symptom Indices, which assessed 5 urinary obstructive/irritative and 6 bowel symptoms. Patients who received definitive radiotherapy (N=73) and post-prostatectomy radiotherapy (N=38) were analyzed separately. The frequency and severity of symptoms over multiple time points are reported.ResultsAn increasing number of patients had clinically-meaningful urinary and bowel symptoms over the course of radiotherapy. A greater proportion of patients undergoing definitive RT reported clinically-meaningful urinary symptoms at the end of RT compared to baseline in terms of flow (33% vs 19%) and frequency (39% vs 18%). Individuals receiving post-prostatectomy radiation also reported an increase in symptoms including frequency (29% vs 3%) and nocturia (50% vs 21%). Clinically-meaningful bowel symptoms were less commonly reported. Patients receiving definitive RT reported an increase in diarrhea (9% vs 4%) and urgency (12% vs 6%) at the completion of radiotherapy compared to baseline. Both bowel and urinary symptoms approached their baseline levels by the time of first follow-up after treatment completion. The majority of patients who had clinically-meaningful urinary or bowel symptoms during RT did not have them at 2years or beyond, and development of new symptoms long-term was uncommon.ConclusionsThere is a modest increase in urinary and bowel symptoms over the course of treatment for individuals receiving definitive and post-prostatectomy image-guided radiotherapy. These data can help inform both providers and patients regarding the trajectory of symptoms and allow for reasonable expectations regarding toxicity under treatment.



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