ABSTRACT
Objective
To assess the long-term incidence of treatment-related toxicities and quality of life
(QOL) outcomes associated with toxicity after external beam radiotherapy (EBRT) for
prostate cancer.
Methods
We identified all men who had EBRT between 1994-2017 from CaPSURE, a longitudinal,
nationwide prostate cancer registry. CaPSURE was queried for patient-reported and
ICD-9/10 and CPT codes. The Medical Outcomes Studies Short Form 36 and the University
of California, Los Angeles Prostate Cancer Index was used to provide measures of general
health, sexual, urinary and bowel function. Repeated measures mixed models were used
to determine QOL change after onset of toxicity.
Results
From a total of 15,332, 1,744 (11.4%) men had EBRT. The median follow-up was 7.9 years
(IQR 4.3-12.7). The median time to onset of any toxicity including urinary pad usage
in 265 (15.4% at 8 years) men was 4.3 years (IQR 1.8-8.0). The most frequent toxicity
was cystitis (104, 5.9% at 8 years) after a median of 3.7 years (1.3-7.8), gastrointestinal
(48, 2.7% at 8 years) after a median of 4.2 years (IQR 1.3-7.8), followed by urethral
stricture (47, 2.4% at 8 years) after a median of 3.7 years (IQR 1.9-9.1). Repeated
measures mixed models found that onset of cystitis was associated with change in general
health over time.
Conclusions
EBRT for prostate cancer is associated with distinct treatment-related toxicities
which can occur many years after treatment and can affect quality of life. These results
may help men understand the long-term implications of treatment decisions.
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Article info
Publication history
Accepted:
May 10,
2023
Received in revised form:
May 9,
2023
Received:
February 25,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
