Evaluating the impact of radiotherapy vs. active surveillance on quality of life in men with localized prostate cancer

This study examined the impact of different prostate cancer treatments on quality of life. This study concluded stereotactic body radiotherapy (SBRT) and active surveillance resulted in a similar quality of life in the long term.

Radiation therapy (RT) is a common treatment for localized (confined) prostate cancer. External beam RT (EBRT) involves directing high-energy rays from outside the body, at the tumor. SBRT involves delivering a high dose of radiation very precisely to a tumor. Compared to EBRT, it is given over a shorter period of time. Active surveillance (AS) is another option for patients with localized prostate cancer. It involves observing the tumor so that patients are treated only when necessary.

The effect of these treatments on quality of life is not known. 

680 men with localized prostate cancer were included in this study. They were treated with RT or underwent AS. Quality of life was measured before treatment. It was also assessed at 3 months, 12 months, and 24 months after treatment. Patients were asked about sexual dysfunction and bowel and urinary problems. 

When compared to AS, EBRT patients had worse urinary obstruction or irritation symptoms, and sexual dysfunction at 3 months. They also had worse bowel symptoms at 3 months and 24 months. At each point in time, patients receiving SBRT or AS had similar quality of life scores.

This study concluded that SBRT resulted in a better quality of life when compared to EBRT, but similar to AS. 

There were a small number of patients in this study. It is possible that SBRT resulted in worse sexual function and urinary incontinence compared with AS. Larger studies with longer follow-up are needed.