The Effect of Salvage Radiotherapy and its Timing on the Health-related Quality of Life of Prostate Cancer Patients

Marie Anne van Stam; Neil K. Aaronson; Floris J. Pos; J. L H Ruud Bosch; Jacobien M. Kieffer; Corinne N. Tillier; Henk G. van der Poel

doi:10.1016/j.eururo.2016.03.010

The Effect of Salvage Radiotherapy and its Timing on the Health-related Quality of Life of Prostate Cancer Patients

Marie Anne van Stam, Neil K. Aaronson, Floris J. Pos, J. L H Ruud Bosch, Jacobien M. Kieffer, Corinne N. Tillier, Henk G. van der Poel^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background

The impact of salvage radiotherapy (SRT) and its timing on health-related quality of life (HRQoL) in prostate cancer patients is still unclear.

Objective

To compare the HRQoL of patients who underwent SRT with that of patients who underwent radical prostatectomy (RP) only and to investigate whether SRT timing is associated with HRQoL.

Design, setting, and participants

All SRT patients (n = 241) and all RP-only patients (n = 1005) were selected from a prospective database (2004–2015). The database contained HRQoL and prostate problem assessments up to 2 yr after last treatment.

Outcome measurement and statistical analysis

Mixed effects growth modelling adjusting for significant differences in patient characteristics and baseline HRQoL was used to analyze the association between: (1) “treatment” (RP-only vs SRT) and (2) “timing of SRT” with changes in HRQoL.

Results and limitations

SRT patients showed significantly (p < 0.05) poorer recovery from urinary, bowel, and erectile function after their last treatment (clinically meaningful difference for urinary and erectile function). Patients with a longer interval (≥ 7 mo) between RP and SRT reported significantly better sexual satisfaction after SRT (p = 0.02), and a better urinary function recovery (p = 0.03). Limitations of the study include the nonrandom design and the variability in timing of HRQoL measurements.

Conclusions

Up to 2 yr after treatment, SRT patients reported poorer HRQoL in several HRQoL domains compared with RP-only patients, but not in overall HRQoL. Delaying the start of SRT after RP may limit the incidence and duration of urinary and sexual problems. Nevertheless, decisions regarding SRT timing should also be based on the potential benefits in disease recurrence.

Patient summary

Patients who receive radiotherapy after surgery may experience poorer urinary, bowel, and erectile function compared with patients who undergo surgery only. Although more research is needed, delaying radiotherapy seems to limit its impact on urinary and sexual functioning.

Original language	English
Pages (from-to)	751-757
Number of pages	7
Journal	European Urology
Volume	70
Issue number	5
DOIs	https://doi.org/10.1016/j.eururo.2016.03.010
Publication status	Published - Nov 2016

Keywords

Health-related quality of life
Prostate cancer
Salvage radiotherapy
Timing radiotherapy

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10.1016/j.eururo.2016.03.010

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@article{c9bcec02910c419fa2031fbb23954717,

title = "The Effect of Salvage Radiotherapy and its Timing on the Health-related Quality of Life of Prostate Cancer Patients",

abstract = "BackgroundThe impact of salvage radiotherapy (SRT) and its timing on health-related quality of life (HRQoL) in prostate cancer patients is still unclear.ObjectiveTo compare the HRQoL of patients who underwent SRT with that of patients who underwent radical prostatectomy (RP) only and to investigate whether SRT timing is associated with HRQoL.Design, setting, and participantsAll SRT patients (n = 241) and all RP-only patients (n = 1005) were selected from a prospective database (2004–2015). The database contained HRQoL and prostate problem assessments up to 2 yr after last treatment.Outcome measurement and statistical analysisMixed effects growth modelling adjusting for significant differences in patient characteristics and baseline HRQoL was used to analyze the association between: (1) “treatment” (RP-only vs SRT) and (2) “timing of SRT” with changes in HRQoL.Results and limitationsSRT patients showed significantly (p < 0.05) poorer recovery from urinary, bowel, and erectile function after their last treatment (clinically meaningful difference for urinary and erectile function). Patients with a longer interval (≥ 7 mo) between RP and SRT reported significantly better sexual satisfaction after SRT (p = 0.02), and a better urinary function recovery (p = 0.03). Limitations of the study include the nonrandom design and the variability in timing of HRQoL measurements.ConclusionsUp to 2 yr after treatment, SRT patients reported poorer HRQoL in several HRQoL domains compared with RP-only patients, but not in overall HRQoL. Delaying the start of SRT after RP may limit the incidence and duration of urinary and sexual problems. Nevertheless, decisions regarding SRT timing should also be based on the potential benefits in disease recurrence.Patient summaryPatients who receive radiotherapy after surgery may experience poorer urinary, bowel, and erectile function compared with patients who undergo surgery only. Although more research is needed, delaying radiotherapy seems to limit its impact on urinary and sexual functioning.",

keywords = "Health-related quality of life, Prostate cancer, Salvage radiotherapy, Timing radiotherapy",

author = "{van Stam}, {Marie Anne} and Aaronson, {Neil K.} and Pos, {Floris J.} and Bosch, {J. L H Ruud} and Kieffer, {Jacobien M.} and Tillier, {Corinne N.} and {van der Poel}, {Henk G.}",

year = "2016",

month = nov,

doi = "10.1016/j.eururo.2016.03.010",

language = "English",

volume = "70",

pages = "751--757",

journal = "European Urology",

issn = "0302-2838",

publisher = "Elsevier",

number = "5",

}

TY - JOUR

T1 - The Effect of Salvage Radiotherapy and its Timing on the Health-related Quality of Life of Prostate Cancer Patients

AU - van Stam, Marie Anne

AU - Aaronson, Neil K.

AU - Pos, Floris J.

AU - Bosch, J. L H Ruud

AU - Kieffer, Jacobien M.

AU - Tillier, Corinne N.

AU - van der Poel, Henk G.

PY - 2016/11

Y1 - 2016/11

N2 - BackgroundThe impact of salvage radiotherapy (SRT) and its timing on health-related quality of life (HRQoL) in prostate cancer patients is still unclear.ObjectiveTo compare the HRQoL of patients who underwent SRT with that of patients who underwent radical prostatectomy (RP) only and to investigate whether SRT timing is associated with HRQoL.Design, setting, and participantsAll SRT patients (n = 241) and all RP-only patients (n = 1005) were selected from a prospective database (2004–2015). The database contained HRQoL and prostate problem assessments up to 2 yr after last treatment.Outcome measurement and statistical analysisMixed effects growth modelling adjusting for significant differences in patient characteristics and baseline HRQoL was used to analyze the association between: (1) “treatment” (RP-only vs SRT) and (2) “timing of SRT” with changes in HRQoL.Results and limitationsSRT patients showed significantly (p < 0.05) poorer recovery from urinary, bowel, and erectile function after their last treatment (clinically meaningful difference for urinary and erectile function). Patients with a longer interval (≥ 7 mo) between RP and SRT reported significantly better sexual satisfaction after SRT (p = 0.02), and a better urinary function recovery (p = 0.03). Limitations of the study include the nonrandom design and the variability in timing of HRQoL measurements.ConclusionsUp to 2 yr after treatment, SRT patients reported poorer HRQoL in several HRQoL domains compared with RP-only patients, but not in overall HRQoL. Delaying the start of SRT after RP may limit the incidence and duration of urinary and sexual problems. Nevertheless, decisions regarding SRT timing should also be based on the potential benefits in disease recurrence.Patient summaryPatients who receive radiotherapy after surgery may experience poorer urinary, bowel, and erectile function compared with patients who undergo surgery only. Although more research is needed, delaying radiotherapy seems to limit its impact on urinary and sexual functioning.

AB - BackgroundThe impact of salvage radiotherapy (SRT) and its timing on health-related quality of life (HRQoL) in prostate cancer patients is still unclear.ObjectiveTo compare the HRQoL of patients who underwent SRT with that of patients who underwent radical prostatectomy (RP) only and to investigate whether SRT timing is associated with HRQoL.Design, setting, and participantsAll SRT patients (n = 241) and all RP-only patients (n = 1005) were selected from a prospective database (2004–2015). The database contained HRQoL and prostate problem assessments up to 2 yr after last treatment.Outcome measurement and statistical analysisMixed effects growth modelling adjusting for significant differences in patient characteristics and baseline HRQoL was used to analyze the association between: (1) “treatment” (RP-only vs SRT) and (2) “timing of SRT” with changes in HRQoL.Results and limitationsSRT patients showed significantly (p < 0.05) poorer recovery from urinary, bowel, and erectile function after their last treatment (clinically meaningful difference for urinary and erectile function). Patients with a longer interval (≥ 7 mo) between RP and SRT reported significantly better sexual satisfaction after SRT (p = 0.02), and a better urinary function recovery (p = 0.03). Limitations of the study include the nonrandom design and the variability in timing of HRQoL measurements.ConclusionsUp to 2 yr after treatment, SRT patients reported poorer HRQoL in several HRQoL domains compared with RP-only patients, but not in overall HRQoL. Delaying the start of SRT after RP may limit the incidence and duration of urinary and sexual problems. Nevertheless, decisions regarding SRT timing should also be based on the potential benefits in disease recurrence.Patient summaryPatients who receive radiotherapy after surgery may experience poorer urinary, bowel, and erectile function compared with patients who undergo surgery only. Although more research is needed, delaying radiotherapy seems to limit its impact on urinary and sexual functioning.

KW - Health-related quality of life

KW - Prostate cancer

KW - Salvage radiotherapy

KW - Timing radiotherapy

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U2 - 10.1016/j.eururo.2016.03.010

DO - 10.1016/j.eururo.2016.03.010

M3 - Article

C2 - 27016464

AN - SCOPUS:84962167104

SN - 0302-2838

VL - 70

SP - 751

EP - 757

JO - European Urology

JF - European Urology

IS - 5

ER -

The Effect of Salvage Radiotherapy and its Timing on the Health-related Quality of Life of Prostate Cancer Patients

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Keywords

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