SBRT improves QoL but leads to worse sexual function in men with localized prostate cancer
While stereotactic body radiotherapy (SBRT) improves quality of life (QoL) in men with localized prostate cancer, it may lead to worse sexual function and urinary incontinence, a recent study has shown.
Researchers performed a population-based cohort study of 680 men recently diagnosed with localized prostate cancer. Malignancy was treated through SBRT (n=104), external beam radiotherapy (EBRT) without androgen deprivation therapy (n=189) or active surveillance (AS; n=387). Quality of life was assessed using the Prostate Cancer Symptom Indices.
After propensity score matching, participants who received EBRT had significantly worse sexual functioning than their AS counterparts at 3 months (mean difference, 8.0, 95 percent CI, 0.5–15.6). No such differences were reported at baseline nor at 12 and 24 months.
The SBRT group had comparable sexual function to the AS group at all time points, though the possibility of having worse outcomes could not be ruled out due to the range of CI values. A similar trend was reported for urinary incontinence scores, which were similar between the AS and SBRT groups but had the potential to favour AS.
On the other hand, the burden of bowel problems was significantly lighter in patients who received SBRT vs AS at 3, 12 and 24 months. However, the absolute magnitudes of difference were small. No such between-group differences were reported for urinary obstruction and irritation at all time points.
“Patients who received SBRT appeared to have favourable outcomes similar to those on AS in all domains and across all time points through 2 years, although a difference in sexual dysfunction and urinary incontinence cannot be ruled out completely. Larger studies with longer follow-up are needed to confirm these findings,” said researchers.