Living alone, obesity and smoking: Important factors for quality of life after radiotherapy and androgen deprivation therapy for prostate cancer

Figures & data

Table I. Socio-demographic and biological characteristics of 317 survivors with primary prostate cancer included in a retrospective survey after radiotherapy and androgen deprivation therapy, 2006–2008 Odense, Denmark.

	Responders (n = 317)	Non-responders (n = 20)	p-value
Socio-demographic characteristics
Age at treatment (years)
Mean (range)	67.3 (49–77)	64.1 (48–74)	0.008^a
Weight (kg) reported at time of questionnaire
Mean (range)	86.8 (62–159)	NA
Unknown	3
Body mass index (BMI) kg/m^2
Mean (CI)	28.2 (27.7; 28.7)	NA
Range	19.6–63.5
Unknown	11
Relation reported at time of questionnaire		NA
Living alone	41 (13.0%)
Living with a spouse	275 (87.0%)
Unknown	1
Education		NA
Basic (less than 10 years)	130 (41.5%)
Youth (high school)	101 (32.3%)
Medium (profession)	62 (19.8%)
Higher (university)	20 (6.4%)
Unknown	4
Smoking status reported at time of questionnaire		NA
Never smoker	93 (29.6%)
Past smoker	175 (55.7%)
Current smoker	46 (14.7%)
Unknown	3
Medical characteristics
PSA pretreatment serum ng/ml:
Mean (range)	23.8 (2–172 )	26.4 (6–85)	0.618^a
Gleason score:			0.135^b
< 7	104 (32.9%)	5 (25%)
7	146 (46.2%)	6 (30%)
> 7	66 (20.9%)	8 (40%)
Unknown	1	1
Degree of malignancy:			0.162^b
T1	18 (5.7%)	2 (10%)
T2	111 (35.2%)	3 (15%)
T3	186 (59.1%)	15 (75%)
Unknown	2
Radiation dose:*			0.378^b
70 Gy	56 (17.7%)	2 (10%)
78 Gy	261 (82.3%)	18 (90%)
Hormone therapy:
No	4 (1.3%)	2 (10%)
Androgen deprivation therapy (ADT)**	313 (98.7%)	18 (90%)

^at-test. p-values are two-sided and < 0.05 were considered statistically significant.

^bχ² test.

*Radiotherapy was delivered in 2.0 Gy daily fractions, 5 days per week.

**Luteinizing hormone-releasing hormone (LHRH) analogue and/or androgen every third month, usually until one year after radiotherapy or three years in T3 patients.

Figure 1. Proportion of patients responding the EPIC questionnaire with moderate-to-severe urinary, bowel, sexual, and hormonal problems among 317 Danish survivors of primary prostate cancer treated with radiotherapy and androgen deprivation therapy, 2006–2008. Odense, Denmark. The overall bother question in each domain is shown and single items within the domains that changes significantly.

Table II. General quality of life (QoL) scores (SF-12) and disease-specific QoL scores (EPIC) overall and at different times after radiotherapy among 317 survivors with primary prostate cancer included in a retrospective survey after radiotherapy and androgen deprivation therapy, 2006–2008. Odense, Denmark.

	SF-12 and epic mean qol scores (95% CI) score 0 to 100*
QoL after treatment	n	Overall n (317)	1–2 years n (101)	2–3 years n (109)	3–4 years n (107)	p-value^a
SF-12 domain:
Physical (PCS)	283	46.2	46.6	46.8	45.3	0.536
		(45.0–47.4)	(44.6–48.6)	(44.8–48.7)	(43.0–47.6)
Mental (MCS)	283	53.4	51.9	54.3	54.0	0.157
		(52.3–54.5)	(49.8–53.9)	(52.5–56.1)	(52.1–55.8)
EPIC domain:
Urinary summary	300	81.3	81.2	83.3	79.4	0.347
		(79.2–83.5)	(77.4–85.0)	(79.6–87.0)	(75.5–83.3)
Urinary incontinence	300	84.9	85.9	87.4	81.4	0.141
		(82.4–87.5)	(81.9–90.0)	(83.0–91.7)	(76.5–86.2)
Urinary irritative	300	79.1	78.7	81.7	76.9	0.190
		(77.0–81.3)	(74.8–82.6)	(78.6–84.7)	(72.7–81.1)
Bowel summary	295	80.7	79.4	83.9	78.8	0.176
		(78.3–83.1)	(75.2–83.5)	(79.8–87.9)	(74.5–83.2)
Sexual summary	301	17.2	9.3	20.5	21.3	< 0.001
		(14.6–19.9)	(6.1–12.5)	(15.4–25.6)	(16.8–25.9)
Hormonal summary	299	72.9	64.5	74.1	79.9	< 0.001
		(70.3–75.5)	(60.3–68.6)	(69.6–78.6)	(75.6–84.2)

*Higher scores indicating better QoL. Note: SF-12 is standardized to the US population normative values, with a mean score of 50 and a SD of 10.

^aAnalysis of variance. Reported p-values are two-sided, and p < 0.05 considered statistically significant.

Figure 2. Forest plot with hypothesized factors associated to moderate-to-severe reduction of QoL among 317 Danish survivors with primary prostate cancer treated with radiotherapy and androgen deprivation therapy, 2006–2008. Odense, Denmark. Odd ratios are given for SF-12 single-item concepts, and the EPIC overall bother items concerning the domains “urinary”, “bowel” and “sexual”. Since the hormonal domain has no overall bother item, all single items are shown. *Logistic regression analysis adjusted for patient age and time (years) since radiotherapy. ^aReported p-values are two-sided and p < 0.05 considered statistically significant.