Abstract
Background
In the present study, we assessed the effect of prostate gland size on patient-assessed
genitourinary and gastrointestinal (GI) quality of life (QOL) after definitive treatment
of prostate adenocarcinoma with proton beam therapy.
Patients and Methods
As a part of a prospective outcome tracking protocol, 81 patients treated at a single
center between with proton beam therapy completed the Expanded Prostate Cancer Index
Composite (EPIC) questionnaire before treatment and at the follow-up examinations.
We reviewed the dosimetric data, reported as Vx (volume of organ receiving x Gy), and patient-reported QOL at 6 months. Genitourinary QOL was assessed using the
American Urological Association symptom score and EPIC urinary domain score. GI QOL
was assessed using the EPIC GI domain score.
Results
Larger prostate glands were associated with greater bladder V70 (P < .01) and rectal V70 (P < .01). The rectal V70 was < 15% for all patients (range, 4%-13.8%) with the planned treatment volume coverage
(percentage of the prescription dose covering 95% of the volume > 95%) maintained.
Patients with larger prostates did not have a greater change in their American Urological
Association symptom index scores (< 30 cm3, +2.3; 30-49 cm3, +3.2; ≥ 50 cm3, 0.2; P = .06) or urinary domain score (< 30 cm3, −3.6; 30-49 cm3, −3.1; ≥ 50 cm3, +3.8; P = .76) at 6 months after treatment. Also, prostate size was not associated with a
change in the EPIC GI domain score at 6 months after treatment (< 30 cm3, −3.7; 30-49 cm3, −1.1; ≥ 50 cm3, −0.55; P = .67).
Conclusion
Definitive proton beam therapy for prostate cancer to a dose of 79.2 Gy resulted in
excellent patient-reported urinary and GI QOL, independently of the baseline prostate
size. This single-institution finding should be tested further in a multi-institutional
study to confirm the potential limited role of androgen deprivation therapy.
Keywords
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Article info
Publication history
Published online: March 18, 2017
Accepted:
March 10,
2017
Received in revised form:
March 10,
2017
Received:
January 18,
2017
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
