Intensity modulated radiation therapy after radical prostatectomy: Early results show no decline in urinary continence, gastrointestinal, or sexual quality of life

Abstract

PurposeAlthough postprostatectomy radiation therapy (PPRT) has been shown to improve cause-specific survival in select high-risk men, its use may be tempered by the concern for toxicity. Limited data exist regarding the nature of how it may adversely affect quality of life in the era of intensity modulated radiation therapy (IMRT). Methods and MaterialsBetween 2007 and 2010, 78 consecutive men received PPRT. Salvage RT was administered to 61 (78%) men and adjuvant RT to 17 (22%). The median dose of IMRT was 66.6 Gy (range, 60-72). Quality of life (QOL) data were prospectively collected using the Expanded Prostate Cancer Index Composite-26 tool and International Prostate Symptom Score (IPSS) at 2-, 6-, 12-, 18-, and 24-month follow-up visits. Paired t tests and multivariate longitudinal analysis were used to assess the QOL measures at baseline and follow-up. ResultsNo significant changes were observed for any individual QOL domain or IPSS score from baseline through 2-year follow-up. Global urinary irritation or obstruction scores were unchanged to improved over time (82, 81, 89, and 88 at baseline, 2, 12, and 24 months, respectively; baseline to 24 months P = .06). Global urinary continence improved from baseline to 24 months in the subset of patients receiving adjuvant RT, who had higher rates of baseline urinary incontinence more than once daily (64% vs 28%, P = .03) and any pad use (73% vs 32%, P = .01) compared with the salvage subset. Global bowel domain scores were lower at 2 months but improved with time. Sexual domain scores were also reduced at 2 months but otherwise unaffected over follow-up. ConclusionsCompared with baseline, PPRT does not appear to be associated with a significant decline in patient-reported urinary, bowel, or sexual QOL indices 2 years after completion.