We acknowledge PROST-QA Data Coordinating Center Project Management by Jill Hardy, MS (Michigan State University, East Lansing, MI), Erin Najuch and Jonathan Chipman (Dana-Farber Cancer Institute, Boston, MA), and Catrina Crociani, MPH (Beth Israel Deaconess Medical Center, Boston, MA); grant administration by Beth Doiron, BA (Beth Israel Deaconess Medical Center, Boston, MA); and technical support from coordinators at each clinical site. We also acknowledge the help of Mark S. Cary, PhD and Kathleen Propert, ScD (University of Pennsylvania) as well as Meredith M. Regan, ScD (Dana-Farber Cancer Institute) for preliminary analyses in the initial stages of this project.
Article first published online: 22 FEB 2013
Copyright © 2013 American Cancer Society
Volume 119, Issue 9, pages 1729–1735, 1 May 2013
How to Cite
Gray, P. J., Paly, J. J., Yeap, B. Y., Sanda, M. G., Sandler, Howard. M., Michalski, J. M., Talcott, J. A., Coen, J. J., Hamstra, D. A., Shipley, W. U., Hahn, S. M., Zietman, A. L., Bekelman, J. E. and Efstathiou, J. A. (2013), Patient-reported outcomes after 3-dimensional conformal, intensity-modulated, or proton beam radiotherapy for localized prostate cancer. Cancer, 119: 1729–1735. doi: 10.1002/cncr.27956
The last 2 authors contributed equally to this article.
We thank the Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment (PROST-QA) Consortium study group. The PROST-QA Consortium includes contributions in cohort design, patient accrual, and follow-up from the following investigators: Meredith Regan (Dana-Farber Cancer Institute, Boston, MA); Larry Hembroff (Michigan State University, East Lansing, MI); John T. Wei, Dan Hamstra, Rodney Dunn, Laurel Northouse, and David Wood (University of Michigan, Ann Arbor, MI); Eric A Klein and Jay Ciezki (Cleveland Clinic, Cleveland, OH); Jeff Michalski and Gerald Andriole (Washington University, St. Louis, MO); Mark Litwin and Chris Saigal (University of California-Los Angeles Medical Center, Los Angeles, CA); Thomas Greenfield, PhD (Berkeley, CA); Louis Pisters and Deborah Kuban (The University of Texas M. D. Anderson Cancer Center, Houston, TX); Howard Sandler (Cedars Sinai Medical Center, Los Angeles, CA); Jim Hu and Adam Kibel (Brigham and Women's Hospital, Boston, MA); Douglas Dahl and Anthony Zietman (Massachusetts General Hospital, Boston, MA); and Irving Kaplan and Martin G. Sanda (Beth Israel Deaconess Medical Center, Boston, MA).
- Issue published online: 22 APR 2013
- Article first published online: 22 FEB 2013
- Manuscript Accepted: 11 DEC 2012
- Manuscript Revised: 8 DEC 2012
- Manuscript Received: 6 NOV 2012
- 3-dimensional conformal radiotherapy;
- intensity-modulated radiotherapy;
- patient reported outcomes;
- prostate cancer;
- proton therapy;
- quality of life
Recent studies have suggested differing toxicity patterns for patients with prostate cancer who receive treatment with 3-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), or proton beam therapy (PBT).
The authors reviewed patient-reported outcomes data collected prospectively using validated instruments that assessed bowel and urinary quality of life (QOL) for patients with localized prostate cancer who received 3DCRT (n = 123), IMRT (n = 153) or PBT (n = 95). Clinically meaningful differences in mean QOL scores were defined as those exceeding half the standard deviation of the baseline mean value. Changes from baseline were compared within groups at the first post-treatment follow-up (2-3 months from the start of treatment) and at 12 months and 24 months.
At the first post-treatment follow-up, patients who received 3DCRT and IMRT, but not those who received PBT, reported a clinically meaningful decrement in bowel QOL. At 12 months and 24 months, all 3 cohorts reported clinically meaningful decrements in bowel QOL. Patients who received IMRT reported clinically meaningful decrements in the domains of urinary irritation/obstruction and incontinence at the first post-treatment follow-up. At 12 months, patients who received PBT, but not those who received IMRT or 3DCRT, reported a clinically meaningful decrement in the urinary irritation/obstruction domain. At 24 months, none of the 3 cohorts reported clinically meaningful changes in urinary QOL.
Patients who received 3DCRT, IMRT, or PBT reported distinct patterns of treatment-related QOL. Although the timing of toxicity varied between the cohorts, patients reported similar modest QOL decrements in the bowel domain and minimal QOL decrements in the urinary domains at 24 months. Prospective randomized trials are needed to further examine these differences. Cancer 2013. © 2013 American Cancer Society.