In:
BJU International, Wiley, Vol. 119, No. 5 ( 2017-05), p. 667-675
Abstract:
To compare quality‐of‐life (QoL) outcomes at 6 months between men with advanced prostate cancer receiving either transdermal oestradiol ( tE 2) or luteinising hormone‐releasing hormone agonists ( LHRH a) for androgen‐deprivation therapy ( ADT ). Patients and methods Men with locally advanced or metastatic prostate cancer participating in an ongoing randomised, multicentre UK trial comparing tE 2 versus LHRH a for ADT were enrolled into a QoL sub‐study. tE 2 was delivered via three or four transcutaneous patches containing oestradiol 100 μg/24 h. LHRH a was administered as per local practice. Patients completed questionnaires based on the European Organisation for Research and Treatment of Cancer quality of life questionnaire 30‐item core ( EORTC QLQ ‐C30) with prostate‐specific module QLQ PR 25. The primary outcome measure was global QoL score at 6 months, compared between randomised arms. Results In all, 727 men were enrolled between August 2007 and October 2015 (412 tE 2, 315 LHRH a) with QoL questionnaires completed at both baseline and 6 months. Baseline clinical characteristics were similar between arms: median (interquartile range) age of 74 (68–79) years and PSA level of 44 (19–119) ng/mL, and 40% (294/727) had metastatic disease. At 6 months, patients on tE 2 reported higher global QoL than those on LHRH a (mean difference +4.2, 95% confidence interval 1.2–7.1; P = 0.006), less fatigue, and improved physical function. Men in the tE 2 arm were less likely to experience hot flushes (8% vs 46%), and report a lack of sexual interest (59% vs 74%) and sexual activity, but had higher rates of significant gynaecomastia (37% vs 5%). The higher incidence of hot flushes among LHRH a patients appear to account for both the reduced global QoL and increased fatigue in the LHRH a arm compared to the tE 2 arm. Conclusion Patients receiving tE 2 for ADT had better 6‐month self‐reported QoL outcomes compared to those on LHRH a, but increased likelihood of gynaecomastia. The ongoing trial will evaluate clinical efficacy and longer term QoL. These findings are also potentially relevant for short‐term neoadjuvant ADT .
Type of Medium:
Online Resource
ISSN:
1464-4096
,
1464-410X
DOI:
10.1111/bju.2017.119.issue-5
Language:
English
Publisher:
Wiley
Publication Date:
2017
detail.hit.zdb_id:
2019983-1
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