Long-Term Quality of Life in Prostate Cancer Patients Treated With Cesium-131

Purpose: To evaluate long-term patient-reported quality of life (QOL) scores in men with prostate cancer treated at our institution with Cs-131 prostate brachytherapy. Methods and Materials: Patients treated more than 4 years ago with Cs-131 (n=290) were asked to fill out an Expanded Prostate Cancer Index Composite (EPIC) QOL questionnaire and American Urological Association Symptom Score (AUASS) survey, before treatment and at each follow-up appointment. We compared patients' EPIC and AUA scores at baseline with scores at a last follow-up of at least 4 years after treatment using the Wilcoxon signed-rank test. Results: At a median last follow-up of 5.5 years after treatment with Cs-131 prostate brachytherapy there were no clinically significant changes in the EPIC or AUA scores from baseline. There was statistical worsening in the EPIC urinary incontinence subscore. Subset analyses revealed improved QOL outcomes in patients who received external beam radiation therapy or a-blocker therapy, whereas androgen deprivation therapy was not associated with differences in QOL change. Conclusions: Our results demonstrate minimal long-term changes in urinary or bowel patient-reported QOL with Cs-131 prostate brachytherapy. These findings suggest that patients treated with this isotope are able to recover and then maintain their baseline QOL in the long term. (C) 2017 Elsevier Inc. All rights reserved.