Quality of life impact of treatments for localized prostate cancer: Cohort study with a 5 year follow-up
Por:
Ferrer, M, Guedea, F, Suarez, JF, de Paula, B, Macias, V, Marino, A, Hervas, A, Herruzo, I, Ortiz, MJ, de Leon, JP, Sancho, G, Boladeras, A, Ayala, A, Craven-Bratle, J, Avila, M, Cunillera, O, Pardo, Y, Alonso, J, Aguilo, F
Publicada:
1 ago 2013
Resumen:
Purpose: To assess long-term quality of life (QoL) impact of treatments in localized prostate cancer patients treated with radical prostatectomy, external beam radiotherapy or brachytherapy.
Material and methods: Observational, prospective cohort study with pre-treatment QoL evaluation and follow-up until five years after treatment. 704 patients with low or intermediate risk localized prostate cancer were consecutively recruited in 2003-2005. QoL was measured by the EPIC questionnaire, with urinary irritative-obstructive, incontinence, bowel, sexual, and hormonal scores (ranging 0-100).
Results: Brachytherapy's QoL impact was restricted to the urinary domain, Generalized Estimating Equation models showed score changes at five years of -12.0 (95% CI = -15.0, -9.0) in incontinence and -5.3 (95% Cl = -7.5, -3.1) in irritative-obstructive scales. Compared to brachytherapy, radical prostatectomy fared +3.3 (95% Cl = +0.0, +6.5) points better in irritative-obstructive but -17.1 (95% CI = -22.7, -11.5) worse in incontinence. Sexual deterioration was observed in radical prostatectomy (-19.1; 95% CI = -25.1, -13.1) and external radiotherapy groups (-7.5; 95% CI = -12.5, -2.5).
Conclusions: Brachytherapy is the treatment causing the least impact on QoL except for moderate urinary irritative-obstructive symptoms. Our study provides novel long-term valuable information for clinical decision making, supporting brachytherapy as a possible alternative to radical prostatectomy for patients seeking an attempted curative treatment, while limiting the risk for urinary incontinence and sexual impact on QoL. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
Filiaciones:
Ferrer, M:
IMIM Hosp Mar Res Inst, Hlth Serv Res Unit, Barcelona 08003, Spain
Univ Autonoma Barcelona, Bellaterra, Spain
Guedea, F:
Inst Catala Oncol, Serv Oncol Radioterap, Lhospitalet De Llobregat, Spain
Suarez, JF:
Hosp Univ Bellvitge, Serv Urol, Lhospitalet De Llobregat, Spain
de Paula, B:
Inst Oncol Guipuzcoa, San Sebastian, Spain
Macias, V:
Univ Salamanca, Hosp Clin, E-37008 Salamanca, Spain
Hosp Gen Cataluna, Inst Oncol Valles, Barcelona, Spain
Marino, A:
Ctr Oncol Galicia, Serv Oncol Radioterap, La Coruna, Spain
Hervas, A:
Hosp Ramon & Cajal, Serv Oncol Radioterap, E-28034 Madrid, Spain
Herruzo, I:
Hosp Reg Carlos Haya, Serv Oncol Radioterap, Malaga, Spain
Ortiz, MJ:
Hosp Virgen del Rocio, Serv Oncol Radioterap, Seville, Spain
de Leon, JP:
Servicio de Urología, Fundació Puigvert, Barcelona, Spain
Sancho, G:
Servicio de Oncología Radioterápica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Boladeras, A:
Inst Catala Oncol, Serv Oncol Radioterap, Lhospitalet De Llobregat, Spain
Ayala, A:
Inst Oncol Guipuzcoa, San Sebastian, Spain
Craven-Bratle, J:
Servicio de Oncología Radioterápica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Avila, M:
IMIM Hosp Mar Res Inst, Hlth Serv Res Unit, Barcelona 08003, Spain
Cunillera, O:
IMIM Hosp Mar Res Inst, Hlth Serv Res Unit, Barcelona 08003, Spain
Pardo, Y:
IMIM Hosp Mar Res Inst, Hlth Serv Res Unit, Barcelona 08003, Spain
Alonso, J:
IMIM Hosp Mar Res Inst, Hlth Serv Res Unit, Barcelona 08003, Spain
Pompeu Fabra Univ UPF, Barcelona, Spain
Aguilo, F:
Hosp Univ Bellvitge, Serv Urol, Lhospitalet De Llobregat, Spain
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