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Keywords:

  • prostatic neoplasms;
  • conformal radiotherapy;
  • quality of life;
  • neoadjuvant therapy;
  • impotence

Abstract

BACKGROUND

Approximately 189,000 men are diagnosed with prostate carcinoma each year and more than 1 million are living with the disease. Good prognoses and undesirable sequelae accompany each of several available primary and adjuvant treatment options. The current study explored the effects of primary three-dimensional conformal radiotherapy with or without neoadjuvant hormonal therapy on urinary, bowel, and sexual symptoms and health-related quality of life (HRQOL).

METHODS

A prospective, repeated-measures design study included 100 patients. Data from the Medical Outcomes Study Short Form Health Survey (a measure of general HRQOL) and a 12-item symptom questionnaire were collected before the start of radiotherapy, approximately 1–3 months after completion of treatment, and again approximately 5–10 months after completion of treatment for follow-up.

RESULTS

Patients reported few urinary symptoms after treatment. Bowel frequency and urgency were reported more frequently posttreatment and at follow-up. Erectile difficulties, which were common pretreatment, were reported with increased frequency posttreatment and at follow-up. General HRQOL scores were higher than age-related general population norms for men at all three data collection times, but there were significant losses posttreatment for patients' physical functioning and vitality. At the 5–10-month follow-up, physical functioning remained lower but vitality scores regained some of the losses. A more extended follow-up is needed. Neoadjuvant therapy, which was received before the pretreatment data collection, had a deleterious effect on erectile functioning but no interactive effects with the radiotherapy on symptoms or HRQOL.

CONCLUSIONS

Although patients with a diagnosis of prostate carcinoma experienced increased bowel and sexual dysfunction and decreased vitality after radiotherapy, their HRQOL scores remained at or above age-related general population norms. Cancer 2003. © 2003 American Cancer Society.