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Japanese Journal of Clinical Oncology Advance Access published online on March 14, 2006
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyl002
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© 2006 Foundation for Promotion of Cancer Research
Received November 9, 2005
Accepted December 26, 2005

Original Article

Health-Related Quality of Life after Intensity Modulated Radiation Therapy for Localized Prostate Cancer: Comparison with Conventional and Conformal Radiotherapy

Shunichi Namiki 1 *, Shigeto Ishidoya 1, Tatsuo Tochigi 2, Sadafumi Kawamura 2, Masaaki Kuwahara 2, Akito Terai 3, Koji Yoshimura 3, Isao Numata 4, Makoto Satoh 1, Seiichi Saito 1, Yoshihiro Takai 5, Shogo Yamada 6, and Yoichi Arai 1

1 Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan
2 Department of Urology, Miyagi Cancer Center, Natori, Miyagi, Japan
3 Department of Urology, Kurashiki Central Hospital, Kurashiki, Okayama, Japan
4 Department of Urology, Furukawa City Hospital, Furukawa, Japan
5 Department of Radiological Technology, Faculty of Medicine, Tohoku University, Sendai, Japan
6 Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan

* To whom correspondence should be addressed.
Shunichi Namiki, E-mail: namikin{at}uro.med.tohoku.ac.jp


  Abstract

Objective: No previous studies have reported the longitudinal health-related quality of life (HRQOL) for intensity modulated radiation therapy (IMRT). We compared HRQOL after IMRT with that after conventional and after conformal radiation therapy (XRT).

Methods: A total of 110 patients underwent XRT (34 patients underwent conventional radiation therapy and 76 underwent conformal radiation therapy) and 30 underwent IMRT for clinically localized prostate cancer between 2000 and 2002. We measured the general and disease-specific HRQOL using the Medical Outcomes Study 36-Item Health Survey and University of California, Los Angeles, Prostate Cancer Index, respectively.

Results: There were no significant differences in the preoperative characteristics and HRQOL scores of the two groups. Repeated measure analyses of variance revealed significantly different patterns of alteration in several general HRQOL domains between XRT and the IMRT groups. In the urinary domain, there was no difference in the alteration patterns between the two groups. The XRT group suffered worse bowel function at 3 and 6 months than the IMRT group (P < 0.05). In the XRT group, sexual function decreased at 3 months and remained substantially lower than the baseline level. However, the IMRT group showed no significant difference from the baseline level at any of the observation periods. At 18 months the XRT group showed worse sexual function than the IMRT group.

Conclusion: The two approaches showed different longitudinal profiles regarding general and disease-specific HRQOL during the first 2 years after treatment. The IMRT approach produced little impairment in bowel and sexual function.

Keywords: prostate cancer; intensity modulated radiation therapy; conventional radiotherapy; conformal radiation therapy; quality of life.
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