Journal of Clinical Oncology, Vol 14, 2258-2265, Copyright © 1996 by American Society of Clinical Oncology
Outcomes of external-beam radiation therapy for prostate cancer: a study of Medicare beneficiaries in three surveillance, epidemiology, and end results areas
FJ Fowler Jr, MJ Barry, G Lu-Yao, JH Wasson and L Bin
Center for Survey Research, University of Massachusetts, Boston 02125, USA.
PURPOSE: This study was designed to obtain representative estimates of the
quality of life and probabilities of possible adverse effects among
Medicare-age patients treated with external-beam radiation therapy for
prostate cancer. METHODS: Patients treated for local or regional prostate
cancer with high-energy external-beam radiation between 1989 and 1991 were
sampled from a claims data base of the Surveillance, Epidemiology, and End
Results (SEER) program from three regions. Patients were surveyed primarily
by mail, with telephone follow-up evaluation of non-respondents. There were
621 respondents (83% response rate). The results were compared with data
from a previously published national survey of Medicare-age men who had
undergone radical prostatectomy. RESULTS: Although they were older at the
time of treatment, radiation patients were less likely than surgical
patients to wear pads for wetness (7% v 32%) and had a lower rate of
impotence (23% v 56% for men < 70 years), while they were more likely to
report problems with bowel dysfunction (10% v 4%). Both groups reported
generally positive feelings about their treatments. Radiation and surgical
patients reported similar rates of additional subsequent treatment (24% v
26% at 3 years after primary treatment). However, radiation patients were
less likely to say they were cancer-free, and they reported more worry
about cancer than did surgical patients. CONCLUSION: The health-related
quality of life of radiation and surgical patients, on average, is similar,
but the pattern of experience with adverse consequences of treatment
differs by treatment.
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