Patient-reported functional outcomes following external beam radiation therapy for prostate cancer with and without a high-dose rate brachytherapy boost: A national population-based study

Matthew G. Parry*, Julie Nossiter, Thomas E. Cowling, Arunan Sujenthiran, Brendan Berry, Paul Cathcart, Noel W. Clarke, Heather Payne, Jan van der Meulen, Ajay Aggarwal

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Background and purpose: Little is known about the functional outcomes and health-related quality of life (HRQoL) following external beam radiation therapy (EBRT) combined with a high-dose rate brachytherapy boost (EBRT-BB) for the treatment of prostate cancer. We aimed to compare patient-reported outcomes of EBRT to those of EBRT-BB. Methods and materials: Patients diagnosed with intermediate-risk, high-risk or locally advanced prostate cancer (April 2014 to September 2016), who received EBRT in the English National Health Service within 18 months of diagnosis and responded to a national patient questionnaire, were identified from the National Prostate Cancer Audit. Adjusted linear regression was used to estimate differences in functional EPIC-26 domains and HRQoL (EQ-5D-5L) between treatment groups. Non-inferiority of EBRT-BB was determined if the lower 95% confidence limit did not exceed the established minimal clinically important difference (MCID). Results: Of the 13,259 included men, 12,503 (94.3%) received EBRT and 756 (5.7%) received EBRT-BB. EBRT-BB was non-inferior compared to EBRT for the urinary incontinence, sexual, bowel and hormonal EPIC-26 domains. EBRT-BB resulted in significantly worse urinary irritation/obstruction scores than EBRT (−6.1; 95% CI: −8.8 to −3.4) but uncertainty remains as to whether this difference is clinically important (corresponding MCID of 5). Conclusions: There is no evidence to suggest that EBRT-BB results in any clinically important detriment in functional outcomes or HRQoL compared to men receiving EBRT only. Whilst statistically significantly worse urinary irritation/obstruction outcomes were reported in the EBRT-BB cohort, the threshold for a clinically significant difference was not exceeded and further research is required for confirmation.

Original languageEnglish
Pages (from-to)48-55
Number of pages8
JournalRadiotherapy and Oncology
Volume155
DOIs
Publication statusPublished - Feb 2021

Keywords

  • Brachytherapy boost
  • External beam radiation therapy
  • High-dose-rate
  • Patient-reported outcomes
  • Prostate cancer

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