Health-related quality of life after adjuvant and salvage postoperative radiotherapy for prostate cancer - a prospective analysis.

Abstract

The aim of the study was to analyze health-related quality of life changes after postoperative radiotherapy (RT) for prostate cancer. A group of 101 patients has been surveyed prospectively before (time A), at the last day (B), two months after (C) and >1 year after (D) RT using a validated questionnaire (Expanded Prostate Cancer Index Composite) with urinary, bowel, sexual and hormonal domains. The prostatic fossa was treated with a four-field box technique up to a total dose of 66.6 Gy. While median urinary scores reached baseline levels already two months after radiotherapy (function/bother scores at time A-B-C-D: 94/89-89/75-94/89-94/89; A vs. B: p<0.01), bowel problems needed a longer time to recover (function/bother scores at time A-B-C-D: 96/100-85/89-88/93-96/100; A vs. B/C: p<0.01). Greater bladder volumes inside specific isodoses were associated with temporary significantly lower urinary bother scores and chronically lower urinary incontinence scores. Only 7% of patients reported of erections firm enough for intercourse before RT, so that RT-associated sexual toxicity played a minor role. In contrast to bowel symptoms, acute urinary problems recover very soon after the end of postoperative RT. After >1 year, only minor HRQOL changes occurred in comparison to baseline scores.