Quality Of Life, 5 Years After I-125 Brachytherapy For Localised Prostate Cancer

There are many treatment options for early stage prostate cancer and, therefore, quality of life (QOL) after treatment influences the treatment decisions for many men. The aim of this prospective longitudinal study was to quantify the QoL in patients post permanent I-125 prostate brachytherapy. A total of 150 patients treated at the Leeds Teaching Hospitals from 2002–2003 with I-125 prostate brachytherapy alone were invited to register their urinary, bowel, sexual, and hormonal function pretreatment and at regular time intervals thereafter, using the Expanded Prostate Cancer Index Composite (EPIC) tool. A total of 126 patients responded initially, although only 94 patients responded (75%) at 5 years. Previous analysis at 3 years showed a maximum deterioration in mean urinary and sexual EPIC score 4–6 weeks after implant. Following this, there was steady improvement with urinary function returning to pretreatment levels at 12 months. Subsequent analysis at 5 years after treatment showed no difference in mean summary for urinary, bowel, and hormonal EPIC scores from pretreatment. In addition, there was no change in the subscales function and bother for urinary, bowel, and hormonal EPIC scores. In contrast, once the acute radiotherapy reaction had resolved, mean sexual summary, and the subscales sexual function and bother improved in the first 12 months, but never returned to pretreatment levels. Age was a significant independent predicting factor for sexual summary and the subscale function at all time points (p < 0.001) but not for the subscale bother. There was no difference in urinary, bowel, and hormonal function 5 years after treatment when compared to preimplant function. Our results suggest that sexual function does not return to the pretreatment function postimplant. Age was a significant independent predicting factor for sexual function postimplant, but in time, it had a lesser effect on the patient's reported QOL.