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