Health-Related Quality of Life in I-125 Prostate Brachytherapy Patients Treated with and without Volume-Reducing Hormone Therapy: Results of a Short-Term Prospective Study

Abstract

This study describes the differences in short-term effects of health-related quality of life (HRQOL) in I-125 prostate brachytherapy patients who were treated with and without volume-reducing hormone therapy. Prostate cancer patients (N = 312) filled out questionnaires on HRQOL (European Organization of Research and Treatment of Cancer Quality of Life Questionnaire [EORTC-QLQ]-C30 and EORTC-QLQ-PR25) before treatment and 6 weeks and 3 months after treatment. HRQOL was compared between the two groups: Patients who were receiving brachytherapy (n = 233) and patients who were receiving brachytherapy with volume-reducing hormone therapy (n = 79). Duration of androgen ablation was 9 months, starting 3 months before I-125 implantation. After treatment, patients reported significant and clinically relevant decreased scores on the following subscales: Global health status, role functioning, social functioning, pain, insomnia, bowel symptoms and functioning, and treatment-related functions, regardless of the therapy they received. Results showed that prostate cancer patients receiving brachytherapy with volume-reducing hormone therapy also experienced lower treatment-related functions and lower sexual function. Significant time by treatment interaction effects were found for treatment-related functions. The subscale treatment-related functions was the only scale that showed a difference over time, between treatments, and time by treatment. The differences in HRQOL between brachytherapy and brachytherapy with volume-reducing hormone therapy are small; they both decrease HRQOL and increase treatment-related problems. A long-term prospective study on long-term effects on HRQOL is needed to obtain a more comprehensive view of the consequences of a specific treatment modality over time. Our results can help to identify the problems patients face after brachytherapy with or without hormone therapy; these problems deserve additional attention during the period of recovery.