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Excellent quality-of-life outcomes after proton therapy for prostate cancer

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Men 60 years old and younger have excellent quality-of-life outcomes after proton therapy for prostate cancer, according to findings published in the January 17th online issue of Cancer.

Proton therapy is a highly conformal radiotherapy that delivers much less radiation dose to nontargeted normal tissues than does conventional radiation therapy.

“Quality of life following treatment of prostate cancer is a critical issue for patients, and they need to be well informed of all treatment options, including proton therapy, prior to making any final treatment decision,” Dr. Bradford S. Hoppe from University of Florida Proton Therapy Institute, Jacksonville, Florida told Reuters Health in an email.

Dr. Hoppe and colleagues investigated patient-reported health-related quality-of-life outcomes, with an emphasis on sexual outcomes, in 262 men aged 60 years and younger with prostate cancer who received definitive treatment with proton therapy alone.

After a median follow-up of 24 months (range, 6-53 months), only 1 patient had developed a biochemical recurrence.

Urinary incontinence scores worsened only slightly from 95.8 at baseline to 92.2 at 2 years, at which point only 1.8% of men reported using a pad to manage urge incontinence.

Potency rates declined by 11% from baseline through 2 years, and 94% of the subgroup of men without diabetes, body-mass index below 30, and baseline International Index of Erectile Function (IIEF) score above 21 were potent 2 years after treatment.

Nearly three-quarters of men (73%) reported “no erectile dysfunction” or “mild erectile dysfunction” after 2 years, compared with 86% of men at baseline, and the number of men actively engaging in sexual intercourse at least weekly only dropped by 11% at 2 years.

Higher penile bulb mean dose and higher proton therapy dose independently lowered sexual summary scores, whereas only the presence of diabetes significantly impaired potency.

“Proton therapy is an effective prostate cancer treatment for men under 60, with reduced risk of side effects like incontinence and impotence that may be improvements over surgical outcomes,” Dr. Hoppe concluded.

“We do intend to continue following these men to evaluate disease control and quality-of-life issues and will hopefully be able to report 5 year results in the future,” Dr. Hoppe added.


Cancer 17 January 2012