Prostate cancer: SBRT, watchful waiting yield similar QoL at 2 years

  • Moon DH & et al.
  • Eur Urol
  • 8 Mar 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Stereotactic radiation therapy (SBRT) does not deteriorate QoL in patients with localized prostate cancer vs active surveillance (AS) at 2 years.
  • Conventionally fractionated external beam radiation therapy (EBRT) worsens sexual dysfunction and urinary obstruction/irritation at 3 months and bowel symptoms at 3 and 24 months vs AS.

Why this matters

  • Data comparing QoL for patients receiving SBRT vs conventionally fractionated EBRT or AS are insufficient.
  • Larger studies with longer follow-up are required to confirm these findings.

Study design 

  • 680 men with newly diagnosed localized prostate cancer received SBRT, EBRT without androgen deprivation therapy, or AS.
  • Funding: Patient-Centered Outcomes Research Institute; US Department of Health and Human Services.

Key results

  • All QoL domain scores in patients who received SBRT were similar to those who received AS at all points (3, 12, and 24 months).
  • Patients who received EBRT without ADT vs AS had statistically significantly worse:
    • Sexual dysfunction at 3 months (mean difference [MD], 8.0; 95% CI, 0.5-15.6).
    • Urinary obstruction and irritation at 3 months (MD, 10.8; 95% CI, 7.5-14.2).
    • Bowel scores at 3 months (MD, 4.6; 95% CI, 2.0-7.3) and 24 months (MD, 3.2; 95% CI, 0.2-6.2).

Limitations

  • Nonrandomized trial.
  • Small sample size.

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