{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T14:58:34Z","timestamp":1770821914210,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2016,12,21]],"date-time":"2016-12-21T00:00:00Z","timestamp":1482278400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Stereotactic body radiation therapy (SBRT) for localized prostate cancer involves high\u2010dose\u2010per\u2010fraction radiation treatments. Its use is increasing, but concerns remain about treatment\u2010related toxicity. The authors assessed the incidence and predictors of a global decline in health\u2010related quality of life (HRQOL) after prostate SBRT.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>From 2008 to 2014, 713 consecutive men with localized prostate cancer received treatment with SBRT according to a prospective institutional protocol. Expanded Prostate Cancer Index Composite (EPIC\u201026) HRQOL data were collected at baseline and longitudinally for 5 years. EPIC\u201026 is comprised of 5 domains. The primary endpoint was defined as a decline exceeding the clinically detectable threshold in \u22654 EPIC\u201026 domains, termed <jats:italic>multidomain decline<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The median age was 69 years, 46% of patients had unfavorable intermediate\u2010risk or high\u2010risk disease, and 20% received androgen\u2010deprivation therapy. During 1 to 3 months and 6 to 60 months after SBRT, 8% to 15% and 10% to 11% of patients had multidomain declines, respectively. On multivariable analysis, lower baseline bowel HRQOL (odds ratio, 1.8; 95% confidence interval, 1.2\u20102.7; <jats:italic>P<\/jats:italic> &lt; .01) and baseline depression (odds ratio, 5.7; 95% confidence interval, 1.3\u201024.3; <jats:italic>P<\/jats:italic> = .02) independently predicted for multidomain decline. Only 3% to 4% of patients had long\u2010term multidomain declines exceeding twice the clinical threshold, and 30% of such declines appeared to be related to prostate cancer treatment or progression of disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Prostate SBRT has minimal long\u2010term impact on multidomain decline, and the majority of more significant multidomain declines appear to be unrelated to treatment. This emphasizes the importance of focusing not only on the side effects of prostate cancer treatment but also on other comorbid illnesses that contribute to overall HRQOL. <jats:bold><jats:italic>Cancer<\/jats:italic> 2017;123:1635\u20131642.<\/jats:bold> \u00a9 <jats:italic>2017 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.30519","type":"journal-article","created":{"date-parts":[[2016,12,21]],"date-time":"2016-12-21T12:59:14Z","timestamp":1482325154000},"page":"1635-1642","source":"Crossref","is-referenced-by-count":15,"title":["Predictors of multidomain decline in health\u2010related quality of life after stereotactic body radiation therapy (SBRT) for prostate cancer"],"prefix":"10.1002","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2331-3758","authenticated-orcid":false,"given":"Robert T.","family":"Dess","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology University of Michigan Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William C.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Michigan Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simeng","family":"Suy","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Georgetown University Washington District of Columbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Payal D.","family":"Soni","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Michigan Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae Y.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Michigan Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed E.","family":"Abugharib","sequence":"additional","affiliation":[{"name":"Department of Oncology Sohag University Sohag Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary S.","family":"Zumsteg","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Cedars\u2010Sinai Medical Center Los Angeles California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix Y.","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of California\u2010San Francisco San Francisco California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel A.","family":"Hamstra","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Texas Oncology Irving Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean P.","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Georgetown University Washington District of Columbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel E.","family":"Spratt","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Michigan Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,12,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.11.054"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2014.00321"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-717X-9-1"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.02.014"},{"key":"e_1_2_8_6_1","unstructured":"Institute of Clinical Research\u2010Clinical Trials and Statistics Unit Division of Clinical Studies.The Prostate Advances in Comparative Evidence (PACE) Study: International randomised study of laparoscopic prostatectomy vs stereotactic body radiotherapy (SBRT) and conventionally fractionated radiotherapy vs SBRT for early stage organ\u2010confined prostate cancer. 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