Health-related quality of life after carbon-ion radiotherapy for prostate cancer: a 3-year prospective study

Int J Urol. 2014 Apr;21(4):370-5. doi: 10.1111/iju.12294. Epub 2013 Oct 9.

Abstract

Objectives: To assess 3-year health-related quality of life of patients treated with carbon ion radiotherapy for prostate cancer.

Methods: A total of 213 patients received carbon-ion radiotherapy at a total dose of 66 Gy equivalent in 20 fractions over 5 weeks, and neoadjuvant and adjuvant androgen deprivation therapy were administered for high-risk patients for at least 12 months. A health-related quality of life assessment was carried out at four time-points (immediately before the initiation of carbon-ion radiotherapy, immediately after, 12 and 36 months after completion of carbon-ion radiotherapy) using Functional Assessment of Cancer Therapy General and for Prostate Cancer Patients.

Results: The evaluable response rates among all responses were more than 94%. Overall, a significant decrease in the scores of the health-related quality of life 12 months after carbon-ion radiotherapy returned to their baseline levels at 36 months. Additionally, no significant decrease was observed in the scores at any of the assessment time-points compared with their baseline scores in the group of carbon-ion radiotherapy without androgen deprivation therapy; however, the presence of morbidity and biochemical failure significantly worsened the scores, and the decreases in the scores did not improve even at 36 months after carbon-ion radiotherapy.

Conclusions: An assessment based on a subjective scoring system shows a significant decrease in health-related quality of life at 12 months after carbon-ion radiation therapy, which tends to return to baseline levels at 36 months. The presence of morbidity and biochemical failure significantly worsen health-related quality of life scores. Further controlled studies focusing on health-related quality of life assessment in patients with prostate cancer are warranted.

Keywords: androgen deprivation therapy; biochemical failure; carbon-ion radiotherapy; health-related quality of life; morbidity.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Androgen Antagonists / therapeutic use*
  • Carbon Radioisotopes / therapeutic use
  • Chemoradiotherapy, Adjuvant / methods*
  • Follow-Up Studies
  • Humans
  • Kallikreins / blood
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Morbidity
  • Neoplasm Grading
  • Neoplasm Staging
  • Prospective Studies
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / mortality
  • Prostatic Neoplasms / pathology*
  • Prostatic Neoplasms / therapy*
  • Quality of Life*
  • Radiation Dosage
  • Surveys and Questionnaires

Substances

  • Androgen Antagonists
  • Carbon Radioisotopes
  • KLK3 protein, human
  • Kallikreins
  • Prostate-Specific Antigen