PMID- 33075390 OWN - NLM STAT- MEDLINE DCOM- 20210423 LR - 20210423 IS - 1879-0887 (Electronic) IS - 0167-8140 (Linking) VI - 155 DP - 2021 Feb TI - Patient-reported functional outcomes following external beam radiation therapy for prostate cancer with and without a high-dose rate brachytherapy boost: A national population-based study. PG - 48-55 LID - S0167-8140(20)30855-0 [pii] LID - 10.1016/j.radonc.2020.10.019 [doi] AB - BACKGROUND AND PURPOSE: Little is known about the functional outcomes and health-related quality of life (HRQoL) following external beam radiation therapy (EBRT) combined with a high-dose rate brachytherapy boost (EBRT-BB) for the treatment of prostate cancer. We aimed to compare patient-reported outcomes of EBRT to those of EBRT-BB. METHODS AND MATERIALS: Patients diagnosed with intermediate-risk, high-risk or locally advanced prostate cancer (April 2014 to September 2016), who received EBRT in the English National Health Service within 18 months of diagnosis and responded to a national patient questionnaire, were identified from the National Prostate Cancer Audit. Adjusted linear regression was used to estimate differences in functional EPIC-26 domains and HRQoL (EQ-5D-5L) between treatment groups. Non-inferiority of EBRT-BB was determined if the lower 95% confidence limit did not exceed the established minimal clinically important difference (MCID). RESULTS: Of the 13,259 included men, 12,503 (94.3%) received EBRT and 756 (5.7%) received EBRT-BB. EBRT-BB was non-inferior compared to EBRT for the urinary incontinence, sexual, bowel and hormonal EPIC-26 domains. EBRT-BB resulted in significantly worse urinary irritation/obstruction scores than EBRT (-6.1; 95% CI: -8.8 to -3.4) but uncertainty remains as to whether this difference is clinically important (corresponding MCID of 5). CONCLUSIONS: There is no evidence to suggest that EBRT-BB results in any clinically important detriment in functional outcomes or HRQoL compared to men receiving EBRT only. Whilst statistically significantly worse urinary irritation/obstruction outcomes were reported in the EBRT-BB cohort, the threshold for a clinically significant difference was not exceeded and further research is required for confirmation. CI - Copyright (c) 2020 Elsevier B.V. All rights reserved. FAU - Parry, Matthew G AU - Parry MG AD - Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, United Kingdom; Clinical Effectiveness Unit, Royal College of Surgeons of England, United Kingdom. Electronic address: mparry@rcseng.ac.uk. FAU - Nossiter, Julie AU - Nossiter J AD - Clinical Effectiveness Unit, Royal College of Surgeons of England, United Kingdom. FAU - Cowling, Thomas E AU - Cowling TE AD - Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, United Kingdom. FAU - Sujenthiran, Arunan AU - Sujenthiran A AD - Clinical Effectiveness Unit, Royal College of Surgeons of England, United Kingdom. FAU - Berry, Brendan AU - Berry B AD - Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, United Kingdom; Clinical Effectiveness Unit, Royal College of Surgeons of England, United Kingdom. FAU - Cathcart, Paul AU - Cathcart P AD - Department of Urology, Guy's and St Thomas' NHS Foundation Trust, United Kingdom. FAU - Clarke, Noel W AU - Clarke NW AD - Department of Urology, The Christie and Salford Royal NHS Foundation Trusts, United Kingdom. FAU - Payne, Heather AU - Payne H AD - Department of Oncology, University College London Hospitals, London, United Kingdom. FAU - van der Meulen, Jan AU - van der Meulen J AD - Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, United Kingdom. FAU - Aggarwal, Ajay AU - Aggarwal A AD - Department of Radiotherapy, Guy's and St Thomas' NHS Foundation Trust, United Kingdom; Department of Cancer Epidemiology, Population, and Global Health, King's College London, United Kingdom. LA - eng GR - DRF-2018-11-ST2-036/DH_/Department of Health/United Kingdom GR - MR/S020470/1/MRC_/Medical Research Council/United Kingdom GR - NIHR300599/DH_/Department of Health/United Kingdom PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20201017 PL - Ireland TA - Radiother Oncol JT - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology JID - 8407192 SB - IM MH - *Brachytherapy/adverse effects MH - Humans MH - Male MH - Patient Reported Outcome Measures MH - Prospective Studies MH - *Prostatic Neoplasms/radiotherapy MH - Quality of Life MH - State Medicine OTO - NOTNLM OT - Brachytherapy boost OT - External beam radiation therapy OT - High-dose-rate OT - Patient-reported outcomes OT - Prostate cancer COIS- Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: J.v.d.M. reports a contract with the Healthcare Quality Improvement Partnership for the provision of the National Prostate Cancer Audit (www.npca.org,uk) funded by the Healthcare Quality Improvement Partnership (www.hqip.org.uk). H.P. has attended and received honoraria for advisory boards, travel expenses to medical meetings, and served as a consultant for AstraZeneca, Astellas, Janssen, Sanofi Aventis, Takeda, Ipsen, Ferring, Sandoz, and Novartis. N.W.C. has attended and received honoraria for advisory boards, travel expenses to medical meetings, and served as a consultant for AstraZeneca, Astellas, Bayer, Janssen, Sanofi Aventis, Takeda, Ipsen and Ferring. EDAT- 2020/10/20 06:00 MHDA- 2021/04/24 06:00 CRDT- 2020/10/19 20:09 PHST- 2020/08/30 00:00 [received] PHST- 2020/10/11 00:00 [accepted] PHST- 2020/10/20 06:00 [pubmed] PHST- 2021/04/24 06:00 [medline] PHST- 2020/10/19 20:09 [entrez] AID - S0167-8140(20)30855-0 [pii] AID - 10.1016/j.radonc.2020.10.019 [doi] PST - ppublish SO - Radiother Oncol. 2021 Feb;155:48-55. doi: 10.1016/j.radonc.2020.10.019. Epub 2020 Oct 17.