• Traitements

  • Combinaison de traitements localisés et systémiques

  • Prostate

External Beam Radiation Therapy or Brachytherapy With or Without Short Course Neoadjuvant Androgen Deprivation Therapy : Results of a Multi-Center, Prospective Study of Quality of Life

Menée à partir de questionnaires auprès de 573 patients atteints d'un cancer de la prostate de stade précoce traité par radiothérapie externe ou curiethérapie en combinaison ou non avec un traitement anti-androgénique néoadjuvant, cette étude multicentrique compare l'effet des différents protocoles thérapeutiques sur la qualité de vie des patients, notamment sur les fonctions sexuelles

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 multi-center 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 : 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 radiation therapy (EBRT) or brachytherapy (BT). HRQOL was measured with the EPIC-26 questionnaire at 2, 6, 12, and 24 months after the initiation of NADT. We used Chi-square or Fisher's Exact test to compare the shift percentages between groups that did or did not receive NADT. Analyses were conducted at the two-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 baseline versus 24 months, 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 to 14%, 13% and 16% in the EBRT group, respectively. Conclusion : Compared to baseline, at 2 years participants receiving NADT plus EBRT compared with EBRT alone had worse HRQOL, as measured by the ability to reach orgasms, quality of erections, and ability to function sexually. However, there was no difference in the ability to have an erection, frequency of erections, overall sexual function, hot flashes, breast tenderness/enlargement, feeling depressed, lack of energy or change in body weight. The improved survival in intermediate and high-risk patients receiving ADT and EBRT necessitates pre-treatment counseling of the HRQOL impact of ADT and EBRT.

http://dx.doi.org/10.1016/j.ijrobp.2017.02.019

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