Population-based patient-reported quality of life outcomes following low-dose-rate versus high-dose-rate brachytherapy monotherapy for low-intermediate risk prostate cancer

Wee Loon Ong; Melanie Evans; Nathan Papa; Scott Williams; Jeremy Millar

doi:10.1111/1754-9485.13596

Population-based patient-reported quality of life outcomes following low-dose-rate versus high-dose-rate brachytherapy monotherapy for low-intermediate risk prostate cancer

J Med Imaging Radiat Oncol. 2023 Oct;67(7):789-795. doi: 10.1111/1754-9485.13596. Epub 2023 Oct 12.

Authors

Wee Loon Ong^{1

2

3}, Melanie Evans², Nathan Papa², Scott Williams^{4

5}, Jeremy Millar^{1

2}

Affiliations

¹ Alfred Health Radiation Oncology, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
² Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
³ Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
⁴ Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
⁵ Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia.

PMID: 37828817
DOI: 10.1111/1754-9485.13596

Abstract

Introduction: To evaluate patient reported quality of life outcomes (QoL) following low-dose-rate brachytherapy (LDR-BT) and high-dose-rate brachytherapy (HDR-BT) monotherapy for prostate cancer at a population-based setting.

Methods: The study comprised men with low-intermediate risk prostate cancer in the Prostate Cancer Outcomes Registry Victoria (PCOR-Vic), who were treated with LDR-BT or HDR-BT monotherapy between 2015 and 2020 and completed the Expanded Prostate Cancer Index Composite (EPIC-26) questionnaire 12-month post-treatment. Men who had ADT were excluded (n = 12). Differences in substantial symptoms (i.e. 'moderate' or 'big' problem on a 5-point Likert scale) between LDR-BT and HDR-BT arms were evaluated using Pearson's chi-squared test. Multivariable linear regressions were used to estimate differences in EPIC-26 urinary, bowel and sexual functional domain scores between LDR-BT and HDR-BT arms.

Results: Overall, 198 men were included in this study, of which 167 (84%) had LDR-BT and 31 (16%) had HDR-BT. 9 (4.6%), 10 (5.1%) and 56 (28%) reported substantial symptoms for overall urinary, bowel and sexual function at 12-month post-treatment, with no significant difference between LDR-BT and HDR-BT arms. The adjusted mean differences in urinary incontinence, urinary obstructive, bowel and sexual function domain scores between LDR-BT and HDT-BT were: -3.53 (-8.21 to 1.14), -1.27 (-6.88 to 4.35), -0.01 (-5.63 to 5.63) and -8.68 (-21.44 to 4.07) respectively - these were not statistically significant and did not meet the minimal clinically important difference.

Conclusion: This is the first Australian population-based study comparing QoL in men who had LDR-BT and HDR-BT, with no statistically or clinically significant differences in QoL observed at 12-month post-treatment.

Keywords: brachytherapy; prostate cancer; quality of life; registry.

MeSH terms

Australia
Brachytherapy*
Humans
Male
Patient Reported Outcome Measures
Prostatic Neoplasms* / radiotherapy
Quality of Life
Radiotherapy Dosage

Grants and funding

Movember Foundation