Health-related Quality of Life, Psychological Distress, and Fatigue in Metastatic Castration-resistant Prostate Cancer Patients Treated with Radium-223 Therapy

Overview

Journal Prostate Cancer Prostatic Dis

Specialties Oncology
Urology

Date 2022 Jul 8

PMID 35804188

Authors

Maarten J van der Doelen

Irma M Oving

Dirk N J Wyndaele

Jean-Paul van Basten

Frederiek Terheggen

Addy C M van de Luijtgaarden

Wim J G Oyen

W Dick van Schelven

Franchette van den Berkmortel

Niven Mehra

Marcel J R Janssen

Judith B Prins

Winald R Gerritsen

Jose A E Custers

Inge M van Oort

Affiliations

Soon will be listed here.

Abstract

Background: Radium-223 is a registered treatment option for symptomatic bone metastatic castration-resistant prostate cancer (mCRPC). Aim of this multicenter, prospective observational cohort study was to evaluate health-related quality of life (HR-QoL), psychological distress and fatigue in mCRPC patients treated with radium-223.

Methods: Primary endpoint was cancer-specific and bone metastases-related HR-QoL, as measured by the EORTC QLQ-C30 and BM-22 questionnaires. Secondary endpoints were psychological distress and fatigue, evaluated by the HADS and CIS-Fatigue questionnaires. Outcomes were analyzed for the total cohort and between subgroups (1-3 versus 4-5 versus 6 radium-223 injections). A trajectory analysis was performed to explore HR-QoL patterns over time.

Results: In total, 122 patients were included for analysis. Baseline HR-QoL, pain intensity, psychological distress and fatigue were worse in patients who did not complete radium-223 therapy. In patients who completed therapy, stabilization of HR-QoL was perceived and psychological distress and fatigue remained stable, whereas clinically meaningful and statistically significant deterioration of HR-QoL, psychological distress and fatigue over time was observed in patients who discontinued radium-223 therapy. Trajectory analysis revealed that HR-QoL deterioration over time was more likely in patients with baseline opioid use, low hemoglobin and high alkaline phosphatase levels.

Conclusions: Patients who discontinued radium-223 therapy showed worse HR-QoL, psychological distress and fatigue at baseline and more frequent deterioration of HR-QoL, psychological distress and fatigue over time when compared to patients who completed therapy. Specific attention with regard to HR-QoL during follow-up is indicated in patients with opioid use, low hemoglobin and high alkaline phosphatase levels before radium-223 therapy initiation.

Clinical Trial Registration Number: NCT04995614.

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