The effect of high dose rate brachytherapy in combination with external beam radiotherapy on men's health-related quality of life and sexual function over a 2 year time span.

Abstract

AIM: To investigate changes in health-related quality of life and sexual function in men after high dose rate (HDR) brachytherapy and external beam radiotherapy (EBRT), with or without androgen deprivation therapy, for localised prostate cancer. MATERIALS AND METHODS: Eligible men who had undergone HDR brachytherapy/EBRT for their prostate cancer completed questionnaires before any treatment (baseline) and at 3 monthly intervals. The European Organization for Research and Treatment of Cancer (EORTC) C30 quality of life measure (QLQ-C30), the PR25 prostate-specific supplement and the International Index of Erectile Function-Short Form (IIEF-SF) were completed. An analysis of changes from baseline to 2 years, for the 87 men who completed surveys, was carried out. RESULTS: The mean EORTC QLQ-C30 quality of life scores, urinary, bowel and sexual symptoms had all improved. However, improvements did not return men to baseline levels at 2 years. Sexual function as measured by both scales was least likely to recover. There were no differences due to androgen deprivation therapy. Minimally important differences were still reported by men at 2 years as follows: urinary (36%), bowel (24%), hormone treatment side-effects (40%), IIEF-SF (55%). Discrepancies between mean and minimally important differences changes are explained by some men remaining more affected by their therapy than others. CONCLUSION: The findings do not support our first hypothesis that urinary, bowel and sexual problems in these men will return to baseline levels once therapy is completed and 2 years have elapsed. Our findings indicate the changes men experience are significant, do occur early, and many do not resolve in the longer term.