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. 2017 Jul 1;5(2):119-128.
doi: 10.15212/FMCH.2017.0133.

Symptoms predicting health-related quality of life in prostate cancer patients treated with localized radiation therapy

Chao-Pin Hsiao  1 , Mea-Kuang Chen  2 , Kathy J Meyers  1 , Leorey N Saligan  3
Affiliations

Symptoms predicting health-related quality of life in prostate cancer patients treated with localized radiation therapy

Chao-Pin Hsiao et al. Fam Med Community Health. .

Abstract

Objective: Patient-reported health-related quality-of-life (HRQOL) measures can provide guidance for treatment decision making, symptom management, and discharge planning. HRQOL is often influenced by the distress experienced by patients from disease or treatment-related symptoms. This study aimed to identify symptoms that can predict changes in HRQOL in men undergoing external beam radiation therapy (EBRT) for nonmetastatic prostate cancer (NMPC).

Methods: Fifty-one men with NMPC scheduled for EBRT were assessed at the baseline, at the midpoint of EBRT, and at the end of EBRT. All participants received 38-42 daily doses of EBRT (five times a week), depending on the stage of their disease. Validated questionnaires were administered to evaluate depressive symptoms, urinary and sexual functions, bowel issues, symptom-related distress, fatigue, and HRQOL. Pearson correlations, repeated-measures ANOVA, and multiple regressions examined the relationships among variables.

Results: Intensification of symptoms and increased symptom-related distress, with a corresponding decline in HRQOL, were observed during EBRT in men with NMPC. Changes in symptoms and symptom distress were associated with changes in HRQOL at the midpoint of EBRT (r=-0.37 to -0.6, P=0.05) and at the end of EBRT (r=-0.3 to -0.47, P=0.01) compared with the baseline. The regression model comprising age, body mass index, Gleason score, T category, androgen-deprivation therapy use, radiation dose received, symptoms (urinary/sexual/bowel problems, fatigue), and overall symptom distress explained 70% of the variance in predicting HRQOL. Urinary problems and fatigue significantly predicted the decline in HRQOL during EBRT.

Conclusion: Identifying specific symptoms that can influence HRQOL during EBRT for NMPC can provide feasible interventional targets to improve treatment outcomes.

Keywords: Symptoms; health-related quality of life; prostate cancer; radiation therapy; symptom distress.

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Conflict of interest statement

Conflict of interest The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Changes in the American Urological Association (AUA), Sexual Health Inventory for Men (SHIM), symptom indexes of symptoms for urinary, bowel, and sexual function problems (SISYM), symptom indexes of symptom-related distress for urinary, bowel, and sexual function (SISD), revised Piper Fatigue Scale (rPFS), and Functional Assessment of Cancer Therapy–Prostate (FACT-P) scores during external beam radiation therapy (EBRT) from the baseline (day 0, D0) to the midpoint of EBRT (day 19 to day 21; D21) and from the baseline (D0) to the end of EBRT (day 38–day 42, D42). Two asterisks indicates P<0.001.
Fig. 2
Fig. 2
Trajectory of health-related quality of life (HRQOL) measured by the Functional Assessment of Cancer Therapy–Prostate (lower scores corresponds to worse HRQOL) in prostate cancer patients during external beam radiation therapy (EBRT) at the baseline (day 0, D0), at the midpoint of EBRT (day 19–day 21, D21), and at the end of EBRT (day 38–day 42, D42). Mean HRQOL scores of all study participants worsened at the midpoint and at completion of EBRT compared with the baseline. Two asterisks indicates P<0.001.
See this image and copyright information in PMC

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