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Related Experiment Video

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Long-Term Patient-Reported Bowel and Urinary Quality of Life in Patients Treated with Intensity-Modulated

Kimberly R Gergelis1, Miao Bai2, Jiasen Ma3

  • 1Department of Radiation Oncology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA.

Current Oncology (Toronto, Ont.)
|April 25, 2025
PubMed
Summary

Intensity-modulated proton therapy (IMPT) shows better long-term bowel function outcomes compared to intensity-modulated radiotherapy (IMRT) for prostate cancer patients. IMPT resulted in a smaller decrease in bowel function scores at 24 months post-treatment.

Keywords:
EPIC-26intensity-modulated proton therapyintensity-modulated radiotherapyprostate cancerquality of life

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Medical Physics

Background:

  • Intensity-modulated radiotherapy (IMRT) and intensity-modulated proton therapy (IMPT) are advanced radiation techniques for localized prostate cancer.
  • Patient-reported outcomes are crucial for evaluating the long-term impact of these treatments.

Purpose of the Study:

  • To compare long-term patient-reported bowel and urinary outcomes between IMRT and IMPT for localized prostate cancer.
  • To assess the clinical meaningfulness of changes in bowel function (BF), urinary irritative/obstructive symptoms (UO), and urinary incontinence (UI) using EPIC-26 scores.

Main Methods:

  • A cohort of patients with clinical T1-T2 prostate cancer treated with IMRT or IMPT between 2015-2018 was analyzed.
  • Changes in EPIC-26 BF, UO, and UI domain scores were evaluated from baseline to 24 months post-radiotherapy.
  • A clinically meaningful change was defined as a score change greater than 50% of the baseline standard deviation.

Main Results:

  • At 24 months post-radiotherapy, the IMRT cohort experienced a significant and clinically meaningful decline in mean BF scores (-4.52, p=0.003).
  • The IMPT cohort showed a non-significant decline in BF scores (-1.88, p=0.046), with a lower proportion of patients experiencing clinically relevant BF reduction (25.93% vs. 47.37%, p=0.017).
  • No statistically significant or clinically relevant differences were observed in UI and UO scores between the IMRT and IMPT groups.

Conclusions:

  • Intensity-modulated proton therapy (IMPT) demonstrates a superior profile in preserving long-term bowel function compared to intensity-modulated radiotherapy (IMRT) in prostate cancer patients.
  • Both treatment modalities showed comparable long-term effects on urinary obstructive/irritative symptoms and incontinence.