期刊
CLINICAL ONCOLOGY
卷 25, 期 5, 页码 321-327出版社
ELSEVIER SCIENCE LONDON
DOI: 10.1016/j.clon.2013.01.001
关键词
High dose rate brachytherapy boost; hypofractionation; prostate cancer; quality of life; randomised trial
类别
资金
- UK Department of Health
- Mount Vernon Cancer Research Funds
- National Cancer Research Network, Mount Vernon Hospital
Aim: To compare prospective, long-term quality of life in patients randomised to external beam radiotherapy (EBRT) alone or with a boost of high dose rate (HDR) brachytherapy. Materials and methods: In total, 216 patients participating in the UK randomised trial of EBRT +/- HDR brachytherapy were included in this analysis. EBRT delivering 55 Gy in 20 fractions was compared with EBRT followed by HDR brachytherapy of 2 x 8.5 Gy. Quality of life was assessed using the Functional Assessment of Cancer Therapy-Prostate (FACT-P) and FACT-G (General) questionnaires, administered before radiotherapy, at 6 months and bi-annually thereafter. Differences in mean FACT global scores and erectile function between treatment arms were compared using chi-squared tests. Results: Over a 10.5 year follow-up, no difference in FACT-G, FACT-P or Trial Outcome Index (TOI) scores was seen between treatments and means were similar to their pretreatment values. Mean erectile function scores in arm 2 were similar to arm 1, but were significantly lower than the pretreatment mean (P <= 0.002). There was no evidence that quality of life deteriorated with increasing follow-up time in any of the four FACT domains. Conclusions: The improved biochemical control of disease seen in these patients with EBRT + HDR brachytherapy coupled with equitoxic early and late urinary and bowel morbidity, indicate a therapeutic advantage, which has now been confirmed by the results for general and prostate-related quality of life changes, despite a decline in erectile function. (c) 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
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