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Radical prostatectomy versus high-dose irradiation in localized/locally advanced prostate cancer: A Swedish multicenter randomized trial with patient-reported outcomes
Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden.
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2015 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 54, no 6, 875-881 p.Article in journal (Refereed) Published
Abstract [en]

Background . Treatment of localized prostate cancer (PC) is controversial. This is the fi rst randomized study compar-ing an open surgery procedure (radical prostatectomy) with a combination of high-dose rate brachytherapy (2 10 Gy) and external beam radiotherapy (25 2 Gy) in PC patients in Sweden 1996 – 2001. The two randomization arms were compared regarding differences in patients-reported outcomes, such as complications and health-related quality of life (HRQoL). Material and methods . The patients had localized/locally advanced PC, clinical category T1b – T3a, N0, M0 and PSA 50 ng/ml. All underwent total androgen blockade (six months). Self-reported HRQoL and symptoms including urinary, bowel, and sexual side effects were investigated prospectively before randomization and 12 and 24 months after randomization. A total of 89 patients were randomized and completed the EORTC QLQ C-33 and EORTC PR-25 questionnaires. Results . Over the study period, there were no discernible differences in HRQoL, or complications between the two groups. Emotional functioning, however, improved statistically signifi cantly over time, whereas Social functioning decreased, and fi nancial diffi culties increased. No statistically signifi cant differences in group-by-time interactions were found. The survival rate was 76%. Only eight patients (9%) died of PC. Conclusion . Open radical prostatectomy and the combined high-dose rate brachytherapy with external beam radiation appeared to be comparable in the measured outcomes. It was not possible to draw any conclusion on the effi cacy of the two treatments due to insuffi cient power of the study.

Place, publisher, year, edition, pages
Informa Healthcare , 2015. Vol. 54, no 6, 875-881 p.
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Clinical Medicine
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URN: urn:nbn:se:liu:diva-118972DOI: 10.3109/0284186X.2014.974827ISI: 000354479800009PubMedID: 25362844OAI: oai:DiVA.org:liu-118972DiVA: diva2:818193
Note

Funding Agencies|Sweden: the King Gustav V Jubilee Clinic Cancer Research Foundation in Gothenburg; Sweden: Swedish Cancer Society; Sweden: Cancer Society Jubilee Fund in Stockholm; Sweden: Schering Plough (Owe Nylander)

Available from: 2015-06-08 Created: 2015-06-05 Last updated: 2016-03-24Bibliographically approved

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Damm, Ole
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Faculty of Medicine and Health SciencesDepartment of Urology in ÖstergötlandDivision of Clinical Sciences
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