Transient Adverse Quality-of-Life Impact of Radiotherapy Added to Androgen-Deprivation Therapy in Locally Advanced Prostate Cancer
In a study reported in the Journal of Clinical Oncology, Brundage et al found that the addition of radiotherapy to androgen-deprivation therapy in patients with locally advanced prostate cancer in the NCIC CTG PR3/MRC PR07 trial had a transient negative impact on health-related quality of life over long-term follow-up. Interim analysis of the trial at a median follow-up of 6 years showed a significant overall survival benefit of adding radiotherapy.
Study Details
In the trial, 1,205 patients were randomly assigned to androgen-deprivation therapy or androgen-deprivation therapy with radiotherapy. Health-related quality of life was assessed at baseline and every 6 months thereafter using the European Organisation for Research and Treatment of Cancer (EORTC) Core Questionnaire and a prostate cancer–specific checklist or the Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire. Five function domains and nine symptom domains considered relevant to androgen-deprivation therapy and radiotherapy were analyzed.
Health-Related Quality-of-Life Outcomes
Baseline questionnaires were completed by 1,028 patients (88%; EORTC = 181, FACT-P = 847). At 6 months, patients who had received radiotherapy had significantly poorer scores for bowel symptoms (P = .02), diarrhea (P < .001), urinary function (P = .003), and erectile function (P = .008) and in FACT-P domains of physical well-being (P = .001), functional well-being (P = .004), and global assessment (P = .002). At 12 months, the radiotherapy group had significantly poorer scores for bowel symptoms (P = .02), diarrhea (P = .03), and erectile function (P = .03), with no significant differences between groups in EORTC or FACT-P domains. At 3 years, there were no significant differences between groups for any symptoms or domains. Both groups showed significant deterioration over time for FACT-P total score, treatment outcome index, and physical and functional well-being.
The investigators concluded: “The addition of [radiotherapy] to [androgen-deprivation therapy] for patients with locally advanced prostate cancer significantly improved overall survival and had only modest and transient negative impact on relevant domains of [health-related quality of life].”
Michael D. Brundage, MD, of the Cancer Clinic of Southeastern Ontario and Queen’s University, Kingston, is the corresponding author for the Journal of Clinical Oncology article.
The study was supported by the Canadian Cancer Society Research Institute, National Cancer Institute, and UK Medical Research Council. For full disclosures of the study authors, visit jco.ascopubs.org.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
