Prostate cancer: hypofractionated radiation and patient-reported QoL

  • Nossiter J & al.
  • J Clin Oncol
  • 2 Jan 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Hypofractionated radiotherapy (HRT) was associated with significantly better sexual and hormonal function scores vs conventional radiotherapy (CRT) in a real-world setting in patients with localized prostate cancer, but these differences are not considered clinically meaningful.

Why this matters

  • Recent guidelines recommend routine use of HRT with a moderately hypofractionated regimen across all risk groups, independent of age, comorbidity, anatomy, or baseline urinary function.

Study design

  • Survey response data of 13,131 men with prostate cancer treated with radiotherapy, who responded to questionnaire that included Expanded Prostate Cancer Index Composite short-form (EPIC-26) and EuroQoL EQ-5D-5L.
  • The minimal clinically important difference between treatments by domain:
    • Urinary incontinence: 6 points.
    • Urinary irritation/obstruction: 5 points.
    • Sexual function: 10-12 points.
    • Bowel function: 4 points.
    • Hormonal disturbance: 4 points.
  • Funding: None disclosed.

Key results

  • 64.2% of patients received CRT, and 35.8% had HRT.
  • Compared with CRT, HRT was associated with significantly higher adjusted mean differences in:
    • EPIC-26 sexual function score: 3.3 points (P<.001 and>
    • Hormonal function score: 3.2 points (P<.001>
  • No statistically significant differences in scores were observed between groups for EQ-5D-5L (P=.87), bowel function (P=.09), urinary incontinence (P=.26), or irritation/obstruction (P=.098).

Limitations

  • Questionnaire-based study.
  • Patient-reported outcomes immediately before treatment were unknown.