QoL Differences Across Prostate Cancer Treatments Show Insignificant Change After 6 Years

A 15-year follow-up of patient-reported outcomes after treatment for prostate cancer did not reveal substantial differences in quality of life from a 6-year follow-up, according to findings published in Clinical and Translational Radiation Oncology.

“Not only were differences between modalities not different from a middle term of follow up of a median of 6.2 years, but the differences within patients did not meet a meaningful clinical difference across any Expanded Prostate Cancer Index (EPIC) domain,” wrote lead and corresponding author Zachary A. Seymour, MD, of the Beaumont Health Department of Radiation Oncology in Dearborn, Michigan, and coauthors. “This included urinary incontinence, which continued to decline in all patient groups and no group disproportionately so more than any other treatment cohort.”

The study looked at 15-year patient-reported outcomes among 401 men treated for prostate cancer: 330 had radical prostatectomy, 41 had 3D conformal radiation therapy, and 30 had brachytherapy. Researchers compared 15-year EPIC surveys with surveys taken 2 to 6 years after treatment.

Although differences in EPIC domains continued at long-term follow-up, quality of life did not substantially evolve from the middle-term follow-up, according to study authors.

Compared with radical prostatectomy, 3D conformal radiation therapy and brachytherapy were associated with persistent worsening in urinary irritative and bowel domains. The study also identified a trend toward worse urinary incontinence with radical prostatectomy, but without statistical differences within radiotherapy options.

“These data indicate that once patients have passed the initial 2 to 6 years after treatment, there are no late dramatic changes in quality of life based on their initial treatment for prostate cancer,” wrote researchers. “This is reassuring that as survival after treatment for prostate cancer increases, our general appreciation for differences in quality of life with different treatment modalities is not substantially changed beyond 6 years. This may place the emphasis on reducing toxicity and meaningful reductions in quality of life in the short term.”

Reference:
Seymour ZA, Daignault-Newton S, McLaughlin PW, et al. Patient reported outcomes for quality of life (QOL) by Expanded Prostate Cancer Index (EPIC) on average 15 years post treatment. Clinical and Translational Radiation Oncology. 2022;36:56-62. doi: 10.1016/j.ctro.2022.05.007.