Long-Term Quality of Life in Prostate Cancer Patients Treated With Cesium-131

Abstract

Toevaluate long-term patient-reported quality of life (QOL) scores in men with prostate cancer treated at our institution with 131Cs prostate brachytherapy. Patients treated more than 4years ago with 131Cs (n=290) were asked to fill out an Expanded Prostate Cancer Index Composite (EPIC) QOL questionnaire and American Urological Association Symptom Score (AUASS) survey, before treatment and at each follow-up appointment. We compared patients' EPIC and AUA scores at baseline with scores at a last follow-up of at least 4years after treatment using the Wilcoxon signed-rank test. At a median last follow-up of 5.5years after treatment with 131Cs prostate brachytherapy there were no clinically significant changes in the EPIC or AUA scores from baseline. There was statistical worsening in the EPIC urinary incontinence subscore. Subset analyses revealed improved QOL outcomes in patients who received external beam radiation therapy or α-blocker therapy, whereas androgen deprivation therapy was not associated with differences in QOL change. Our results demonstrate minimal long-term changes in urinary or bowel patient-reported QOL with 131Cs prostate brachytherapy. These findings suggest that patients treated with this isotope are able to recover and then maintain their baseline QOL in the long term.