Population‐based patient‐reported quality of life outcomes following low‐dose‐rate versus high‐dose‐rate brachytherapy monotherapy for low‐intermediate risk prostate cancer

Abstract Introduction To evaluate patient reported quality of life outcomes (QoL) following low‐dose‐rate brachytherapy (LDR‐BT) and high‐dose‐rate brachytherapy (HDR‐BT) monotherapy for prostate cancer at a population‐based setting. Methods The study comprised men with low‐intermediate risk prostate cancer in the Prostate Cancer Outcomes Registry Victoria (PCOR‐Vic), who were treated with LDR‐BT or HDR‐BT monotherapy between 2015 and 2020 and completed the Expanded Prostate Cancer Index Composite (EPIC‐26) questionnaire 12‐month post‐treatment. Men who had ADT were excluded ( n = 12). Differences in substantial symptoms (i.e. ‘moderate’ or ‘big’ problem on a 5‐point Likert scale) between LDR‐BT and HDR‐BT arms were evaluated using Pearson's chi‐squared test. Multivariable linear regressions were used to estimate differences in EPIC‐26 urinary, bowel and sexual functional domain scores between LDR‐BT and HDR‐BT arms. Results Overall, 198 men were included in this study, of which 167 (84%) had LDR‐BT and 31 (16%) had HDR‐BT. 9 (4.6%), 10 (5.1%) and 56 (28%) reported substantial symptoms for overall urinary, bowel and sexual function at 12‐month post‐treatment, with no significant difference between LDR‐BT and HDR‐BT arms. The adjusted mean differences in urinary incontinence, urinary obstructive, bowel and sexual function domain scores between LDR‐BT and HDT‐BT were: −3.53 (−8.21 to 1.14), −1.27 (−6.88 to 4.35), −0.01 (−5.63 to 5.63) and −8.68 (−21.44 to 4.07) respectively – these were not statistically significant and did not meet the minimal clinically important difference. Conclusion This is the first Australian population‐based study comparing QoL in men who had LDR‐BT and HDR‐BT, with no statistically or clinically significant differences in QoL observed at 12‐month post‐treatment.