Postprostatectomy Radiotherapy Timing and Long-Term Health-Related Quality of Life.

Area of Science:

• Oncology
• Urology
• Radiotherapy

Background:

• The impact of radiotherapy (RT) timing after radical prostatectomy on long-term health-related quality of life (HRQOL) in prostate cancer patients is not well understood.
• Patient-reported outcomes are crucial for evaluating treatment effectiveness beyond survival rates.

Purpose of the Study:

• To assess long-term HRQOL up to 15 years post-prostatectomy in men who received RT or not.
• To compare HRQOL outcomes between early (<12 months) and late (≥12 months) postprostatectomy RT.

Main Methods:

• A prospective, multicenter, longitudinal cohort study involving 1203 men treated with radical prostatectomy.
• HRQOL was measured using the Expanded Prostate Cancer Index Composite, assessing sexual, urinary, bowel, and hormonal domains.
• Men were stratified into prostatectomy only, early RT, and late RT groups; outcomes were analyzed using mixed-effects models.

Main Results:

• Postprostatectomy RT was associated with significant decreases in sexual, incontinence, and urinary irritation HRQOL compared to prostatectomy alone.
• No significant difference in long-term HRQOL was observed between early and late RT groups.
• Men receiving early RT showed improved recovery of sexual, continence, and urinary irritation scores compared to the late RT group.

Conclusions:

• Postprostatectomy RT negatively impacts long-term HRQOL across multiple domains.
• The timing of RT (early vs. late) does not appear to significantly affect long-term HRQOL outcomes.
• Early RT may offer some advantages in the recovery of specific HRQOL domains compared to delayed RT.