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Long-term health-related quality-of-life outcomes after permanent prostate brachytherapy
Jorg W Schafer1, Grit Welzel, Lutz Trojan
1Klinik fur Strahlentherapie und Radioonkologie, Universitatsklinikum Mannheim, Medizinische Fakultat Mannheim, Germany. joerg.schaefer@radonk.ma.uni-heidelberg.de
Background:
We evaluated the long-term health-related quality of life (HRQoL) after modern prostate brachytherapy (PB).
Patients And Methods:
The European Organization for Research and Treatment of Cancer (EORTC) prostate cancer quality-of-life questionnaire, QLQ-PR25, and the modified International Continence Society (ICS) male questionnaire were sent to 296 men treated with PB at the University Medical Center Mannheim. To evaluate the influence of age, we subclassified two groups: group 1 <65 years, group 2 > or =65 years. 258 of the 296 patients were alive at the time of assessment. Of 238 questionnaires (92% response rate), 231 were suitable for analysis. Median follow-up was 51 months.
Results:
Of group 1 77.8% and of group 2 73.4% of the men were in good, very good or excellent health. There was a low rate of moderate (10.4%) or strong (1.0%) symptoms regarding urinary functioning. Stress incontinence was uncommon. Only 28.2% reported moderate or strong (up to 17.6%) symptoms regarding sexual functioning. In group 1 48.6% and in group 2 25.0% of patients reported no or minor erectile dysfunction (p < 0.007). There was no severe overall rectal dysfunction (<2%).
Conclusion:
Our data substantiate the favorable long-term HRQoL outcomes associated with modern PB techniques. Significant age differences were observed in sexual symptoms and less pronounced age differences in urinary symptoms. We found a low rate of urinary symptoms and no evidence of severe rectal dysfunction.