OBJECTIVES: To prospectively investigate the influence of 3-month neoadjuvant hormonal therapy (NHT) before brachytherapy (BT) for low-risk prostate cancer (PCa) on urinary function and health-related quality of life (HRQL). METHODS: Between 2003 and 2008, 300 patients with PCa were treated with BT using (125)I stranded seeds, of whom 86 received 3-month NHT to downsize the prostate before treatment. Urinary complaints were measured on all occasions with the International Prostate Symptom Score (n = 134) and European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire PR25 (EORTC-QLQ-PR25 questionnaire; n = 118) and HRQL with the EORTC-QLQ-C30 (n = 120) questionnaire. RESULTS: Post-BT, urinary function became worse over the first 6 weeks and then improved steadily, but did not return to baseline levels at 1 year. At baseline, the NHT group reported worse urinary function compared with the non-NHT group (P < .01). However, the post-BT improvement of urinary function was better in the NHT group at 3 months (P < .05). Global HRQL, physical, role and social functioning decreased over the first 3 months (P < .05) post-BT but returned to baseline levels within 1 year. Emotional function steadily improved over the 1-year follow-up period (P < .001). The NHT group reported better global HRQL, social and emotional functioning 1 year post-BT compared with baseline (P < 05). All results were adjusted for comorbidity. This is a single-center study with a follow-up of 1 year, thereby potentially limiting the general applicability of the results. CONCLUSIONS: Three months of NHT before BT might positively influence urinary function and HRQL up to 1 year post-BT. Therefore, PCa patients should not be dissuaded from considering NHT followed by BT because of prostate size.
OBJECTIVES: To prospectively investigate the influence of 3-month neoadjuvant hormonal therapy (NHT) before brachytherapy (BT) for low-risk prostate cancer (PCa) on urinary function and health-related quality of life (HRQL). METHODS: Between 2003 and 2008, 300 patients with PCa were treated with BT using (125)I stranded seeds, of whom 86 received 3-month NHT to downsize the prostate before treatment. Urinary complaints were measured on all occasions with the International Prostate Symptom Score (n = 134) and European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire PR25 (EORTC-QLQ-PR25 questionnaire; n = 118) and HRQL with the EORTC-QLQ-C30 (n = 120) questionnaire. RESULTS: Post-BT, urinary function became worse over the first 6 weeks and then improved steadily, but did not return to baseline levels at 1 year. At baseline, the NHT group reported worse urinary function compared with the non-NHT group (P < .01). However, the post-BT improvement of urinary function was better in the NHT group at 3 months (P < .05). Global HRQL, physical, role and social functioning decreased over the first 3 months (P < .05) post-BT but returned to baseline levels within 1 year. Emotional function steadily improved over the 1-year follow-up period (P < .001). The NHT group reported better global HRQL, social and emotional functioning 1 year post-BT compared with baseline (P < 05). All results were adjusted for comorbidity. This is a single-center study with a follow-up of 1 year, thereby potentially limiting the general applicability of the results. CONCLUSIONS: Three months of NHT before BT might positively influence urinary function and HRQL up to 1 year post-BT. Therefore, PCa patients should not be dissuaded from considering NHT followed by BT because of prostate size.
Authors: Hiram Alberto Gay; Jeff M Michalski; Daniel A Hamstra; John T Wei; Rodney L Dunn; Eric A Klein; Howard M Sandler; Chris Saigal; Mark Litwin; Deborah Kuban; Larry Hembroff; Peter Chang; Martin G Sanda Journal: Urology Date: 2013-10-16 Impact factor: 2.649
Authors: Finbar Slevin; Brinda Sethugavalar; Bashar Al-Qaisieh; Peter Bownes; Joshua Mason; Jonathan Smith; David Bottomley; Ann M Henry Journal: J Contemp Brachytherapy Date: 2020-12-16