Hiram A Gay1, Martin G Sanda2, Jingxia Liu3, Ningying Wu3, Daniel A Hamstra4, John T Wei5, Rodney L Dunn5, Eric A Klein6, Howard M Sandler7, Christopher S Saigal8, Mark S Litwin9, Deborah A Kuban10, Larry Hembroff11, Meredith M Regan12, Peter Chang13, Jeff M Michalski14. 1. Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri. Electronic address: hiramgay@wustl.edu. 2. Department of Urology, Emory University School of Medicine, Atlanta, Georgia. 3. Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri. 4. Texas Center for Proton Therapy, Irving, Texas. 5. Department of Urology, University of Michigan, Ann Arbor, Michigan. 6. Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio. 7. Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California. 8. Department of Urology, University of California at Los Angeles, Los Angeles, California. 9. Department of Urology, University of California at Los Angeles, Los Angeles, California; Health Policy and Management, University of California at Los Angeles, Los Angeles, California. 10. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 11. Institute for Public Policy and Social Research, Michigan State University, East Lansing, Michigan. 12. Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts. 13. Department of Surgery, Beth Israel-Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. 14. Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri.
Abstract
PURPOSE: The long-term effects of neoadjuvant androgen deprivation therapy (NADT) with radiation therapy on participant-reported health-related quality of life (HRQOL) have not been characterized in prospective multicenter studies. We evaluated HRQOL for 2 years among participants undergoing radiation therapy (RT) with or without NADT for newly diagnosed, early-stage prostate cancer. METHODS AND MATERIALS: We analyzed longitudinal cohort data from the Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment Consortium to ascertain the HRQOL trajectory of men receiving NADT with external beam RT (EBRT) or brachytherapy. HRQOL was measured using the expanded prostate cancer index composite 26-item questionnaire at 2, 6, 12, and 24 months after the initiation of NADT. We used the χ2 or Fisher exact test to compare the shift in percentages between groups that did or did not receive NADT. Analyses were conducted at the 2-sided 5% significance level. RESULTS: For subjects receiving EBRT, questions regarding the ability to have an erection, ability to reach an orgasm, quality of erections, frequency of erections, ability to function sexually, and lack of energy were in a significantly worse dichotomized category for the patients receiving NADT. Comparing the baseline versus 24-month outcomes, 24%, 23%, and 30% of participants receiving EBRT plus NADT shifted to the worse dichotomized category for the ability to reach an orgasm, quality of erections, and ability to function sexually compared with 14%, 13%, and 16% in the EBRT group, respectively. CONCLUSIONS: Compared with baseline, at 2 years, participants receiving NADT plus EBRT compared with EBRT alone had worse HRQOL, as measured by the ability to reach orgasm, quality of erections, and ability to function sexually. However, no difference was found in the ability to have an erection, frequency of erections, overall sexual function, hot flashes, breast tenderness/enlargement, depression, lack of energy, or change in body weight. The improved survival in intermediate- and high-risk patients receiving NADT and EBRT necessitates pretreatment counseling of the HRQOL effect of NADT and EBRT.
PURPOSE: The long-term effects of neoadjuvant androgen deprivation therapy (NADT) with radiation therapy on participant-reported health-related quality of life (HRQOL) have not been characterized in prospective multicenter studies. We evaluated HRQOL for 2 years among participants undergoing radiation therapy (RT) with or without NADT for newly diagnosed, early-stage prostate cancer. METHODS AND MATERIALS: We analyzed longitudinal cohort data from the Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment Consortium to ascertain the HRQOL trajectory of men receiving NADT with external beam RT (EBRT) or brachytherapy. HRQOL was measured using the expanded prostate cancer index composite 26-item questionnaire at 2, 6, 12, and 24 months after the initiation of NADT. We used the χ2 or Fisher exact test to compare the shift in percentages between groups that did or did not receive NADT. Analyses were conducted at the 2-sided 5% significance level. RESULTS: For subjects receiving EBRT, questions regarding the ability to have an erection, ability to reach an orgasm, quality of erections, frequency of erections, ability to function sexually, and lack of energy were in a significantly worse dichotomized category for the patients receiving NADT. Comparing the baseline versus 24-month outcomes, 24%, 23%, and 30% of participants receiving EBRT plus NADT shifted to the worse dichotomized category for the ability to reach an orgasm, quality of erections, and ability to function sexually compared with 14%, 13%, and 16% in the EBRT group, respectively. CONCLUSIONS: Compared with baseline, at 2 years, participants receiving NADT plus EBRT compared with EBRT alone had worse HRQOL, as measured by the ability to reach orgasm, quality of erections, and ability to function sexually. However, no difference was found in the ability to have an erection, frequency of erections, overall sexual function, hot flashes, breast tenderness/enlargement, depression, lack of energy, or change in body weight. The improved survival in intermediate- and high-risk patients receiving NADT and EBRT necessitates pretreatment counseling of the HRQOL effect of NADT and EBRT.
Authors: Behfar Ehdaie; Coral L Atoria; Amit Gupta; Andrew Feifer; William T Lowrance; Michael J Morris; Peter T Scardino; James A Eastham; Elena B Elkin Journal: Cancer Date: 2011-11-09 Impact factor: 6.860
Authors: Mehrdad Alemozaffar; Meredith M Regan; Matthew R Cooperberg; John T Wei; Jeff M Michalski; Howard M Sandler; Larry Hembroff; Natalia Sadetsky; Christopher S Saigal; Mark S Litwin; Eric Klein; Adam S Kibel; Daniel A Hamstra; Louis L Pisters; Deborah A Kuban; Irving D Kaplan; David P Wood; Jay Ciezki; Rodney L Dunn; Peter R Carroll; Martin G Sanda Journal: JAMA Date: 2011-09-21 Impact factor: 56.272
Authors: Tomasz M Beer; Catherine M Tangen; Lisa B Bland; Maha Hussain; Bryan H Goldman; Thomas G DeLoughery; E David Crawford Journal: Cancer Date: 2006-08-01 Impact factor: 6.860
Authors: James W Denham; Allison Steigler; David S Lamb; David Joseph; Sandra Turner; John Matthews; Chris Atkinson; John North; David Christie; Nigel A Spry; Keen-Hun Tai; Chris Wynne; Catherine D'Este Journal: Lancet Oncol Date: 2011-05 Impact factor: 41.316
Authors: Padraig Warde; Malcolm Mason; Keyue Ding; Peter Kirkbride; Michael Brundage; Richard Cowan; Mary Gospodarowicz; Karen Sanders; Edmund Kostashuk; Greg Swanson; Jim Barber; Andrea Hiltz; Mahesh K B Parmar; Jinka Sathya; John Anderson; Charles Hayter; John Hetherington; Matthew R Sydes; Wendy Parulekar Journal: Lancet Date: 2011-11-02 Impact factor: 79.321
Authors: Malcolm D Mason; Wendy R Parulekar; Matthew R Sydes; Michael Brundage; Peter Kirkbride; Mary Gospodarowicz; Richard Cowan; Edmund C Kostashuk; John Anderson; Gregory Swanson; Mahesh K B Parmar; Charles Hayter; Gordana Jovic; Andrea Hiltz; John Hetherington; Jinka Sathya; James B P Barber; Michael McKenzie; Salah El-Sharkawi; Luis Souhami; P D John Hardman; Bingshu E Chen; Padraig Warde Journal: J Clin Oncol Date: 2015-02-17 Impact factor: 44.544
Authors: Alexander B Nolsøe; Christian Fuglesang S Jensen; Peter B Østergren; Mikkel Fode Journal: Int J Impot Res Date: 2020-12-14 Impact factor: 2.896