Objective: To determine late toxicity and quality of life (QoL) in patients with localized prostate cancer after highdose\r\nintensity-modulated radiotherapy (IMRT).\r\nPatient and methods: This was a prospective study in patients with localized prostate adenocarcinoma who had\r\nbeen treated by IMRT (76 Gy) between February and November 2006. Physicians scored acute and late toxicity\r\nusing the Common Terminology Criteria for Adverse Events (version 3.0). Patients completed cancer and prostatespecific\r\nQoL questionnaires (EORTC QLQ-C30 and QLQ-PR25) before IMRT (baseline) and at 2, 6, 18 and 54 months.\r\nResult: Data were available for 38 patients (median age, 73 years) (18% low risk; 60% intermediate risk; 32% high\r\nrisk). The incidence of urinary and gastrointestinal toxicity was respectively: immediately post IMRT: 36.8% and 23.7%\r\n(grade 1), 5.3% and 5.3% (grade 2), 2.6% and 0% (grade 3); at 18 months: 23.7% and 10.3% (grade 1), 26.3% and\r\n13.2% (grade 2), 0% and 2.6% (grade 3); at 54 months: 34.2% and 23.7% (grade 1), 5.3% and 15.8% (grade 2), 5.3%\r\nand 0% (grade 3). At 54 months, significant worsening was reported by patients for 11/19 QoL items but the\r\nworsening was clinically relevant (>10 points) for 7 items only: physical, role as well as social functioning, fatigue,\r\npain, dyspnoea and constipation. There was no significant difference between 54-month and baseline QoL scores\r\nfor global health, gastrointestinal symptoms, treatment-related symptoms and sexual function. However, there was\r\nsignificant - but clinically non-relevant (<10 points) - worsening of urinary symptom.\r\nConclusion: High-dose IMRT to the prostate with accurate patient positioning did not induce any clinically relevant\r\nworsening in late urinary and gastrointestinal QoL at 54 months. Impaired physical and role functioning may be\r\nrelated to age and comorbidities
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