Alpha Omega Alpha Honor Medical Society

2012 Research Abstract

AUA, RAS, and SHIM-Assessed Quality of Life Changes due to Definitive EBRT to 75.6-81.0 Gy/42-45 Fx vs. EBRT+HDR in Clinically Localized Prostate Cancer Patients who did not receive ADT

Investigator: Alex Cruz, USF Health Morsani College of Medicine

Mentor: Matthew C. Biagioli, H.L. Moffitt Cancer Center, Tampa, Florida

Introduction: Our primary objective was to compare the toxicities of the various modalities in treating patients with prostate cancer. Secondary to this, we assessed various therapeutic techniques, along with their associated toxicities, as they relate to prostate cancer risk stratification.

Method: An IRB approved database was queried for all men with prostate cancer whom received external beam radiation therapy (EBRT) or EBRT + high dose-rate brachytherapy (HDR) without Androgen Deprivation Therapy (ADT) or radical prostatectomy at the H. Lee Moffitt Cancer Center & Research Institute. The patients were treated between January 2004 and December 2012. Their American Urology Association (AUA), and Sexual Health in Males (SHIM) symptom/toxicity data was retrospectively analyzed at baseline, 3 months post-treatment, 6 months post-treatment, 1 year post-treatment, 2 years post-treatment and 3+ years post-treatment. The results between the symptom/toxicity assessments were comparatively assessed.

Results: We identified 168 patients that received EBRT+HDR and 153 that received EBRT alone. Patients that received EBRT+HDR were found to have a significantly elevated AUA score after 3 months of treatment compared to those that received EBRT alone (p < 0.001). The patients that received EBRT+HDR were also found to have significant elevation in their AUA score at 1 year post-treatment when compared to their baseline values (p < 0.004). All other time intervals did not show significant differences between EBRT+HDR and EBRT alone in terms of AUA score symptoms or toxicities.

The patients that underwent EBRT+HDR were also found to have a significant decline in their SHIM scores 1 year post-treatment when compared to the EBRT cohort (p < 0.010). All other time intervals did not show significant differences between EBRT+HDR and EBRT alone in terms of SHIM score symptoms or toxicities.

Conclusion: This is the first institutional comparison of symptoms and toxicities in men with prostate cancer receiving definitive EBRT or EBRT+HDR. The combined radiotherapy (EBRT+HDR) had a significant increase in the toxicities experienced by this group of patients when compared to the EBRT monotherapy.

Updated on September 5, 2013.


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