ABSTRACT
Purpose
We aim to report 1) prevalence, 2) incidence, and 3) late, persistent, substantial
treatment-related symptoms (LAPERS) after low-dose-rate brachytherapy (LDRBT) for
prostate cancer.
Methods and materials
The study comprised men treated with LDRBT in a single Australian institution between
2014 and 2019. All men completed the Expanded Prostate Cancer Index Composite 26 (EPIC-26)
questionnaire pretreatment, and at regular intervals posttreatment. ‘Substantial’
symptoms were defined as ‘moderate’ or ‘big’ problems in EPIC-26 which assesses the
degree of symptom bother for each functional domain. ‘Persistent’ symptoms were defined
as ‘substantial’ symptoms that present in at least half of the ‘late’ followup assessments.
This provided a binary LAPERS outcome (yes/no). Prevalence (at each time point) and
cumulative incidence of substantial symptoms were also reported.
Results
A total of 172 men with ‘baseline’ and at least three ‘late’ followup EPIC-26 were
included in the study. The median followup was 60 months (IQR: 36–74 months). For
overall urinary function, prevalence of substantial symptoms was highest at 10% 6-month
posttreatment, with 5-year cumulative incidence of 18%, but only 2% had LAPERS. For
overall bowel function, prevalence of substantial symptoms was highest at 7% 12-months
posttreatment, with 5-year cumulative incidence of 15%, and only 2% had LAPERS. For
sexual function, prevalence of substantial symptoms was highest at 28% 6-months posttreatment,
with 5-year cumulative incidence of 49%, and 22% had LAPERS (baseline-adjusted LAPERS
17%).
Conclusions
There were considerable differences in late toxicities using different toxicity-reporting
approaches. LAPERS approach is more reflective of ‘true’ late toxicities considering
duration and persistence of symptoms.
Keywords
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Article info
Publication history
Published online: January 25, 2023
Accepted:
January 3,
2023
Received in revised form:
September 25,
2022
Received:
April 25,
2022
Publication stage
In Press Corrected ProofFootnotes
Disclosure: There is no funding for this study. The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.
Identification
Copyright
© 2023 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
