Patient-reported quality of life during radiation treatment for localized prostate cancer: results from a prospective phase II trial

OBJECTIVE To evaluate data collected from a phase II trial to describe the time course and trajectory of patient-reported acute urinary and bowel symptom development during radiation therapy (RT) for prostate cancer. PATIENTS AND METHODS In all, 100 patients with intermediate- or high-risk prostate cancer received 72 Gy of RT to the prostate and seminal vesicles, with 6 months of concurrent androgen deprivation therapy; a rectal balloon was used for prostate immobilization. Patients completed the validated Prostate Cancer Symptom Indices questionnaire every 12 weeks, reporting urinary and bowel symptoms on a four- or five-point Likert scale. A score of =3 in a symptom is associated with clinically meaningful distress. Cumulative incidence of each symptom is reported. Bonferroni corrections of P values were used to adjust for multiple comparisons. RESULTS Urinary symptoms were frequent at baseline and worsened during treatment. By the end of RT, 2850% of patients developed clinically meaningful obstructive and irritative urinary symptoms. Acute bowel symptoms were less frequent. Each bowel symptom increased in frequency by 926% from baseline to end of RT. Urinary incontinence was rare. Overall, symptom burden at the end of treatment was modest. CONCLUSIONS Urinary symptoms were common during RT, and bowel symptoms were less frequent. These results inform patients and physicians during the decision-making process about potential patient quality of life experiences during RT, and also provide a benchmark for comparative effectiveness studies against newer treatments and technologies.