Defining an international research agenda for quality of life in men with prostate cancer

Litwin, Mark S.; Fitzpatrick, John M.; Fosså, Sophie D.; Newling, Don

doi:10.1002/(sici)1097-0045(19990915)41:1<58::aid-pros8>3.0.co;2-3

Cited by 28 publications

(26 citation statements)

References 63 publications

(51 reference statements)

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“…The combination of hyperthermia, androgen suppression and radiotherapy may further improve the clinical outcome. Quality of life is now widely recognized as important in evaluating the effectiveness of prostate cancer therapies [29]. Androgen suppression severely compromises the quality of life [30], whereas hyperthermia does not seem to do so [8].…”

Section: Discussionmentioning

confidence: 99%

Radiotherapy and hyperthermia in the treatment of patients with locally advanced prostate cancer: preliminary results

Vulpen¹,

Leeuw²,

Raaymakers³

et al. 2003

BJU International

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was delivered using a conformal three-field technique, administering 70 Gy in 2-Gy fractions in 7 weeks. RESULTSThe mean initial prostate-specific antigen level was 26 ng/mL. Three patients had a T4 and 23 a T3 tumour; the tumours were classified as well (four), moderately (16) and poorly (six) differentiated. The mean followup was 36 months. In the combined treatments there was no toxicity of more than grade 2. In regional hyperthermia the mean index temperature (T 90 and T 50 , i.e. exceeded by 90% and 50% of the measurements) was 40.2 ∞ C and 40.8 ∞ C, and for interstitial hyperthermia 39.4 ∞ C and 41.8 ∞ C, respectively. All patients survived; seven patients had a biochemical relapse (27%), three in the regional and four in the interstitial group. The actuarial probability of freedom from biochemical relapse was 70% at 36 months for all patients together, 79% for regional and 57% for interstitial. No factors were found that could be used to predict relapse. CONCLUSIONSThe clinical outcome in these patients with advanced localized prostate cancer seems to compare favourably with most series using irradiation alone, and the treatment caused no severe complications.

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Section: Discussionmentioning

confidence: 99%

Radiotherapy and hyperthermia in the treatment of patients with locally advanced prostate cancer: preliminary results

Vulpen¹,

Leeuw²,

Raaymakers³

et al. 2003

BJU International

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“…However, advances in technology like intensity-modulated radiotherapy (IMRT) (6) and improved position verification of the prostate (7,8) have enabled dose escalation while treatment-related complications are minimized. For evaluation of treatment, not only toxicity but also impact on QoL is increasingly important (9).…”

Section: Introductionmentioning

confidence: 99%

Health-Related Quality of Life in Patients With Locally Advanced Prostate Cancer After 76 Gy Intensity-Modulated Radiotherapy vs. 70 Gy Conformal Radiotherapy in a Prospective and Longitudinal Study

Lips

Dehnad

Kruger

et al. 2007

International Journal of Radiation Oncology*Biology*Physics

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Purpose: To compare quality of life (QoL) after 70 Gy conformal radiotherapy with QoL after 76 Gy intensitymodulated radiotherapy (IMRT) in patients with locally advanced prostate carcinoma. Methods and Materials: Seventy-eight patients with locally advanced prostate cancer were treated with 70 Gy three-field conformal radiotherapy, and 92 patients received 76 Gy IMRT with fiducial markers for position verification. Quality of life was measured by RAND-36, the European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30(+3)), and the prostate-specific EORTC QLQ-PR25, before radiotherapy (baseline) and 1 month and 6 months after treatment. Quality of life changes in time (baseline vs. 1 month and baseline vs. 6 months) of $10 points were considered clinically relevant. Results: Differences between the treatment groups for QoL changes over time occurred in several QoL domains. The 76-Gy group revealed no significant deterioration in QoL compared with the 70-Gy group. The IMRT 76-Gy group even demonstrated a significantly better change in QoL from baseline to 1 month in several domains. The conformal 70-Gy group revealed temporary deterioration in pain, role functioning, and urinary symptoms; for the IMRT 76-Gy group a better QoL in terms of change in health existed after 1 month, which persisted after 6 months. For both treatment groups temporary deterioration in physical role restriction occurred after 1 month, and an improvement in emotional role restriction occurred after 6 months. Sexual activity was reduced after treatment for both groups and remained decreased after 6 months. Conclusions: Intensity-modulated radiotherapy and accurate position verification seem to provide a possibility to increase the radiation dose for prostate cancer without deterioration in QoL. Ó 2007 Elsevier Inc.

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“…Hormonal treatments are used for metastatic disease, asymptomatic lymph node metastases, biochemical recurrence, and for patients with localized disease who are poor operative candidates. Health-related (HR) QOL studies have been helpful in shedding light on the effects of androgen deprivation therapy that are difficult to quantify, including sense of well-being, mental health, perception of physical health, and specific side effects, including urinary symptoms, sexual function, and fatigue [119].…”

Section: Quality Of Lifementioning

confidence: 99%

“…However, sildenafil [142], intraurethral alprostadil (MUSE) [143], intrapenile injections of vasoactive drugs [144], and vacuum-assist erection devices have been shown to be safe and effective in other causes of erectile dysfunction and, therefore, they may potentially be Thompson,Shanafelt,Loprinzi 482 useful in men on androgen-deprivation therapy. Intermittent androgen suppression also has been shown to restore potency during the off-therapy periods [119,131].…”

Section: Sexual Dysfunctionmentioning

confidence: 99%

Andropause: Symptom Management for Prostate Cancer Patients Treated With Hormonal Ablation

2003

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Andropause, or the age-related decline in serum testosterone, has become a popular topic in the medical literature over the past several years. Andropause includes a constellation of symptoms related to lack of androgens, including diminished libido, decreased generalized feeling of well-being, osteoporosis, and a host of other symptoms. The andropause syndrome is very prominent in men undergoing hormonal ablation therapy for prostate cancer. Most significant in this population are the side effects of hot flashes, anemia, gynecomastia, depression, cognitive decline, sarcopenia, a decreased overall quality of life, sexual dysfunction, and osteoporosis with subsequent bone fractures. The concept of andropause in prostate cancer patients is poorly represented in the literature. In this article, we review the current literature on the symptoms, signs, and possible therapies available to men who cannot take replacement testosterone. The Oncologist 2003;8:474-487 The Oncologist 2003;8:474-487 www.TheOncologist.comCorrespondence: Charles L. Loprinzi, M.D., Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA. Telephone: 507-284-2511; Fax: 507-266-4972; e-mail: cloprinzi@mayo.edu Received January 14, 2003; accepted for publication July 11, 2003. ©AlphaMed Press 1083-7159/2003 ANDROPAUSEAndropause is defined as an age-related decline in serum testosterone levels in older men to below the normal range in young men, which is associated with a clinical syndrome consistent with androgen deficiency. The syndrome may include decreased muscle strength and/or endurance, decreased pubic and axillary hair, reduced physical function, diminished libido, fatigue, depressed mood, decreased generalized well-being, hot flashes, osteoporosis/osteopenia, and anemia [1].In men, four hormones significantly decrease with age: testosterone, estradiol, dehydroepiandrosterone (DHEA)/ DHEA sulfate (DHEA-S), and growth hormone (GH) [2]. A longitudinal study showed that mean total testosterone levels decreased by 30% between the ages of 25 and 75 and mean free-testosterone levels decreased by as much as 50% [3]. This decline in testosterone is secondary to a decrease in the number of testicular Leydig cells, a decrease in testicular perfusion, and changes in the hypothalamic-pituitary axis [4]. Serum estradiol also decreases in aging men, likely The Oncologist ® LEARNING OBJECTIVESAfter completing this course, the reader will be able to:1. Explain the side effects of hormonal ablation therapy for prostate cancer.2. Provide a list of potential non-hormonal therapies for treatment of vasomotor symptoms.3. Appreciate the impact of hormonal ablation therapy on bone mineral density.Access and take the CME test online and receive one hour of AMA PRA category 1 credit at CME.TheOncologist.com CME CME This material is protected by U.S.

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Defining an international research agenda for quality of life in men with prostate cancer

Cited by 28 publications

References 63 publications

Radiotherapy and hyperthermia in the treatment of patients with locally advanced prostate cancer: preliminary results

Radiotherapy and hyperthermia in the treatment of patients with locally advanced prostate cancer: preliminary results

Health-Related Quality of Life in Patients With Locally Advanced Prostate Cancer After 76 Gy Intensity-Modulated Radiotherapy vs. 70 Gy Conformal Radiotherapy in a Prospective and Longitudinal Study

Andropause: Symptom Management for Prostate Cancer Patients Treated With Hormonal Ablation

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