Measuring Quality Of Life In Low-Risk Prostate Cancer Treated With Surgery, External Beam Radiation Therapy, Or Brachytherapy. Capcirab Project: A Prospective, Multicentric Cohort Study

Similar oncologic outcomes are achieved in Low Risk Prostate Cancer (LR PCa) if treated either with Surgery (Sx), Brachytherapy (BT) or External Beam radiation therapy (RT). Quality of life (QOL) variations during and after treatment (tt) are measurable with questionnaires. We aim to quantify QOL in LR PCa treated with Sx, BT or RT over time, and to compare the validity of EORTC-QLQ-C30/PR25 and CAVIPRES tests against the gold standard (EPIC). Prospective, multicentric cohort study of 3 non-randomized interventions (Sx, BT, RT) evaluating QOL in LR PCa patients (pts) not receiving hormonal tt. EPIC, EORTC QLQ C30 (C30), EORTC QLQ PR 25 (PR 25) and CAVIPRES tests made at 0, 1, 3, 6, 12 and 24 months (m) after tt. Planned size per arm was 133 pts to get accuracy on EPIC but recruitment was not obtained. Median values evaluated on each measure. Differences assessed using the repeated measures ANOVA between the 3 groups and ANOVA between each group. Test items followed a scale of 100 (0 = poor, 100 = the best QOL). Seventy-three pts recruited (2011 – 2014), 2-year follow-up. Ten pts had Sx, 45 BT and 18 RT. EPIC median score for Sx on urinary (UF)/ bowel (BF)/sexual (SF) function at 0, 1, 3, 6, 12 and 24 m was: 96/100/73, 59/98/24, 71/100/30, 91/100/21, 87/98/31, 95/100/31. For BT was 100/100/74, 85/96/67, 90/96/65, 96/96/65, 100/99/65, 100/100/60 respectively. For RT 90/97/54, 85/93/47, 92/97/52, 98/98/56, 95/98/52, 96/97/43. ANOVA repeated measures between the 3 groups showed Statistically significant differences (SSD) as follows: EPIC: UF at all measurements (P < 0.02), SF at 1 m (P < 0.01). C30 had SSD at 1m in social function (SoF) and constipation (P < 0.05). PR25 had SSD on UF at 0 m, SF at 6 and 12 m (P < 0.04). CAVIPRES test had SSD on SF at 1 m (P < 0.001). When ANOVA between 2 groups was used, SSD were found as follows: EPIC: UF 0, 3, 6, 12 m (all groups but RT vs BT 12 m), SF 1 m (all groups). C30: SoF (Sx vs RT and Sx vs BT) over time. PR 25: UF 0 m (RT vs BT) CAVIPRES: SF (Sx vs RT and Sx vs BT). UF was the most affected item, worse in Sx, better in BT, improving with time. SF had SSD after 1 m, mainly on Sx pts. At 12m most of the items improved, yet SF remained affected on Sx pts. C30 showed SoF and constipation changes, whereas PR 25 just found UF differences in certain periods. CAVIPRES had SF differences at 1 m. Increasing recruitment permit to compare more precisely the accuracy of the tests. Being active surveillance now an option in LR PCa, further trials testing QOL with this approach are needed.