Quality of life results from the Prostate Cancer Outcome Study (PCO) after primary radiotherapy
PD-0569
Abstract
Quality of life results from the Prostate Cancer Outcome Study (PCO) after primary radiotherapy
Authors: Bülent Polat1, Nora Tabea Sibert2, Simone Wesselmann2, Sebastian Dieng3, Günter Feick4, Ernst-Günther Carl4, Jan Fichtner5, Martin Burchardt6, Rebekka Kosmala1, Jörg Tamihardja1, Thomas Wiegel7, Michael Flentje8, Christoph Kowalski2
1University hospital Würzburg, Department of radiation oncology, Würzburg, Germany; 2German Cancer Society, -, Berlin, Germany; 3OnkoZert GmbH, -, Neu-Ulm, Germany; 4Federal Association of German Prostate Cancer Patient Support Groups, -, Bonn, Germany; 5Johanniter Krankenhaus Oberhausen, Department of Urology, Oberhausen, Germany; 6University Medicine Greifswald, Department of Urology, Greifswald, Germany; 7University Hospital Ulm, Department of Radiation Oncology, Ulm, Germany; 8University hospital Würzburg, Department of radiation oncology , Würzburg, Germany
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Purpose or Objective
The ongoing observational PCO (Prostate Cancer Outcomes) study compares differences in treatment quality between participating centers in patients with non-metastatic prostate cancer treated with primary radical prostatectomy, definitive radiotherapy (RT) or being under active surveillance or watchful waiting. Here we present quality of life (QoL) data for the RT group.
Material and Methods
Prospective data from certified mainly German prostate cancer centers were evaluated. QoL was measured using the EPIC-26 questionnaire at baseline before treatment initiation and at 12 months thereafter. Questions are categorized within five domains and scored from 0 – 100 points (higher values correspond to better functioning): incontinence, irritative/obstructive functions, bowel function, sexual and vitality/hormonal function. To discriminate between statistically and clinically relevant differences we used MIDs (minimally important differences) with reference values from the literature: incontinence 6, irritative/obstructive 5, bowel function 4, sexual 10 and hormonal 4 points. Student’s t-test for paired samples was applied for comparison of the two time points with a p-value of 0.05 set as statistically significant.
Results
From August 2016 to May 2021 a total of 3,440 RT patients out of 103 centers were enrolled. With 2,603 available questionnaires at 12 months, we reached a response rate of 75.7 %. Median age was 74 years and patients presented with low, intermediate and high-risk/(locally) advanced prostate cancer in 14, 42 and 42%. Median PSA (at follow-up) was 0.39 ng/ml. In total 3,209 (93.3%) patients were treated with external beam RT and 231 (6.7%) with LDR-brachytherapy. Concomitant ADT was given in 851 (24.7%) patients. The main QoL outcome values for each time point and domain were as follows (baseline, 12 months, mean values): 91, 87 for incontinence, 86, 83 for irritative/obstructive, 95, 87 for bowel functions, 42, 28 for sexual and 88, 79 for hormonal functions. All changes were statistically significant (p<0.01). Patients receiving ADT had a relevant decline in the sexual and hormonal domains at one year: 29 vs 19 and 83 vs 71.
Conclusion
One year after definitive RT, changes in continence and irritative/obstructive complaints were minimal and within the MID boundaries. For the other domains, minor but clinically relevant changes were observed.