ESTRO 2024 - Abstract Book

S2465

Clinical - Urology

ESTRO 2024

Quality of Life after Prostatic Fossa RT – a Prospective Study of Patient-reported Outcomes

Michael Keilholz 1 , Jing Ma 1 , Christian Trapp 1 , Nina-Sophie Schmidt-Hegemann 1 , Claus Belka 1,2,3 , Minglun Li 1 , Paul Rogowski 1 1 University Hospital LMU, Department of Radiation Oncology, Munich, Germany. 2 Bavarian Cancer Research Center (BZKF), LMU Klinikum, Munich, Germany. 3 German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany

Purpose/Objective:

Prospective data on quality of life (QoL) during and after postoperative radiotherapy (RT) of the prostatic fossa using modern radiotherapy techniques are sparse. The aim of this study was to evaluate systematically physician reported toxicity and patient-reported quality of life in a prospective manner.

Material/Methods:

Consecutive prostate cancer patients treated with RT of the prostatic fossa between July 2019 and February 2023 were included. Physician-reported toxicity was assessed before RT, weekly during RT, three month post-RT and annually thereafter and graded according to CTCAE v5. Patient-reported QoL was measured using the EORTC global (QLQ-C30) and EORTC prostate cancer module (QLQ-PR25) questionnaires before RT, at the end of RT, three months after RT and annually thereafter. Toxicity and quality of life at different time points were compared using the Wilcoxon test.

Results:

Eighty patients were included, with a median follow-up of 19 months. The median dose to the prostatic fossa was 66 Gy (range: 60-66.5Gy). In case of local recurrence, a simultaneous integrated boost of up to 70 was performed. The median pre-RT PSA level of 0.24 ng/ml decreased to <0.07 ng/ml at three months after RT, remaining stable thereafter. Urinary and bowel symptoms, as reported by physicians, temporarily increased during RT but returned to baseline at follow-up. New grade 2 and 3 toxicities were observed in 18% and 3% of patients, respectively. Among the 45 patients with complete continence at baseline, two and one patients experienced grade 2 and 3 incontinence during follow-up. QLQ-C30 functional scores showed no significant changes during or after RT. Diarrhea and fatigue symptoms worsened at RT completion but normalized afterward. QLQ-PR25 scores for bowel symptoms increased significantly from 4.1/100 to 8.7/100 at RT completion, remaining elevated at 8.6/100 after one year. Urinary symptom scores rose from 22.8/100 to 30.6/100 post-RT and slightly persisted at 25.8/100 after one year. Sexual function scores on QLQ-PR25 remained stable.