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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Predictors of multidomain decline in health-related quality of life after stereotactic body radiation therapy (SBRT) for prostate cancer
Cancer, Volume 123, No. 9, Year 2017
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Description
BACKGROUND: Stereotactic body radiation therapy (SBRT) for localized prostate cancer involves high-dose-per-fraction radiation treatments. Its use is increasing, but concerns remain about treatment-related toxicity. The authors assessed the incidence and predictors of a global decline in health-related quality of life (HRQOL) after prostate SBRT. METHODS: From 2008 to 2014, 713 consecutive men with localized prostate cancer received treatment with SBRT according to a prospective institutional protocol. Expanded Prostate Cancer Index Composite (EPIC-26) HRQOL data were collected at baseline and longitudinally for 5 years. EPIC-26 is comprised of 5 domains. The primary endpoint was defined as a decline exceeding the clinically detectable threshold in ≥4 EPIC-26 domains, termed multidomain decline. RESULTS: The median age was 69 years, 46% of patients had unfavorable intermediate-risk or high-risk disease, and 20% received androgen-deprivation therapy. During 1 to 3 months and 6 to 60 months after SBRT, 8% to 15% and 10% to 11% of patients had multidomain declines, respectively. On multivariable analysis, lower baseline bowel HRQOL (odds ratio, 1.8; 95% confidence interval, 1.2-2.7; P <.01) and baseline depression (odds ratio, 5.7; 95% confidence interval, 1.3-24.3; P =.02) independently predicted for multidomain decline. Only 3% to 4% of patients had long-term multidomain declines exceeding twice the clinical threshold, and 30% of such declines appeared to be related to prostate cancer treatment or progression of disease. CONCLUSIONS: Prostate SBRT has minimal long-term impact on multidomain decline, and the majority of more significant multidomain declines appear to be unrelated to treatment. This emphasizes the importance of focusing not only on the side effects of prostate cancer treatment but also on other comorbid illnesses that contribute to overall HRQOL. Cancer 2017;123:1635–1642. © 2017 American Cancer Society.
Authors & Co-Authors
Dess, Robert T.
United States, Ann Arbor
University of Michigan, Ann Arbor
Jackson, William C.
United States, Ann Arbor
University of Michigan, Ann Arbor
Suy, Simeng
United States, Washington, D.c.
Georgetown University
Soni, Payal D.
United States, Ann Arbor
University of Michigan, Ann Arbor
Lee, Jae Y.
United States, Ann Arbor
University of Michigan, Ann Arbor
Abugharib, Ahmed E.
Egypt, Sohag
Faculty of Medicine
Zumsteg, Zachary S.
United States, Los Angeles
Cedars-sinai Medical Center
Feng, Felix Y.
United States, San Francisco
University of California, San Francisco
Hamstra, Daniel A.
United States, Dallas
Texas Oncology
Collins, Sean P.
United States, Washington, D.c.
Georgetown University
Spratt, Daniel E.
United States, Ann Arbor
University of Michigan, Ann Arbor
Statistics
Citations: 16
Authors: 11
Affiliations: 6
Identifiers
Doi:
10.1002/cncr.30519
ISSN:
0008543X
e-ISSN:
10970142
Research Areas
Cancer
Disability
Mental Health
Study Design
Cohort Study
Case-Control Study
Participants Gender
Male