Quality of life after permanent seed implants

As techniques have improved over time, one would expect the quality of long-term outcomes after permanent seed bachytherapy to improve also.

Schafer et al. have reported the health-related quality of life (HRQoL) of two groups of German patients after “modern” prostate brachytherapy using permanent seed implantation at a median of >4 years of follow-up.

The authors sent two well-validated questionnaires to 296 men treated with prostate brachytherapy for localized disease at the University Medical Center, Mannheim. To evaluate the influence of age, they subclassified the patients into two groups: patients in Group 1 were < 65 years; those in Group 2 were  ≥ 65 years. The authors report the following:

  • Of the 296 patients to whom questionnaires were sent, 258 were alive at the time of assessment.
  • Of 238 questionnaires received (an extraordinary 92 percent response rate), 231 were suitable for analysis.
  • Median follow-up time post-treatment was 51 months.
  • Of the patients in Groups A and B, respectively, 77.8 and 73.4% percent reported being in good, very good or excellent health.
  • There was a low rate of “moderate” (10.4 percent) or “strong” (1.0 percent) symptoms of suboptimal urinary function, and stress incontinence was uncommon.
  • Just over a quarter of all patients (28.2 percent) reported “moderate” or “strong” (up to 17.6 percent) symptoms of suboptimal sexual function; specifically, 48.6 percent of patients in Group A and in 25.0 percent of patients in Group B reported no or minor erectile dysfunction.
  • There appear to have been very few reports of rectal dysfunction (< 2 percent).

Schafer et al. conclude that their data “substantiate the favorable long-term HRQoL outcomes” associated with modern prostate  brachytherapy using permanent seed impant techniques. Comparing the data from the two age groups, they do note the expectable impact of increasing age as related to sexual and urinary symptoms at follow-up.

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