{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:12:56Z","timestamp":1790140376657,"version":"4.0.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:00:00Z","timestamp":1744156800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:00:00Z","timestamp":1744156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Schleswig-Holstein - Campus Kiel"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Urol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Patients with localized prostate cancer have various treatment options. Decision regret from a patient\u2019s view is an unpleasant feeling concerning a decision in health care. We aimed to explore regret and its determinants after external beam radiotherapy (EBRT) with a high dose-rate brachytherapy (HDR-BT) boost as traditional method of treatment intensification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a secondary analysis of a cross-sectional study. Patients were enrolled at least two years after EBRT +\u2009HDR-BT. Decision regret was measured using the Decision Regret Scale (0\u2013100). Covariables included patient characteristics, dose to organs at risk and patient-reported outcomes (PRO) including EPIC- 26, EORTC QLQ-C30, and PSCC. We used Pearson\u2019s correlation and one-way ANOVA analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 108 patients, the median age was 73 and the median interval since treatment was 4\u00a0years. The mean score of decision regret was 11 (SD: 14). No (0), mild (1\u201325), or strong (&gt; 25) decision regret was present in 49% (53\/108), 39% (42\/108), and 12% (13\/108) of the patients, respectively. PRO were associated with stronger decision regret including worse urinary incontinence (r = \u2212 0.198; p\u2009= 0.046), worse urinary irritative\/obstructive symptoms (r = \u2212 0.203; p\u2009= 0.045), worse bowel function (r = \u2212 0.312; p\u2009= 0.001), worse hormonal function (r = \u2212 0.289; p\u2009= 0.003), lower levels of shared-decision making (r = \u2212 0.292; p\u2009= 0.002), and lower patient satisfaction (r = \u2212 0.326; p\u2009&lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Long-term decision regret is mild among patients with prostate cancer treated with EBRT +\u2009HDR-BT. PRO were associated with decision regret which should be respected in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>The study protocol was registered prior to patient accrual on the Open Science Framework (doi.org\/10.17605\/OSF.IO\/A6DC3).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00345-025-05615-3","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T14:54:59Z","timestamp":1744210499000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Decision regret after external beam radiotherapy and high dose-rate brachytherapy boost for prostate cancer"],"prefix":"10.1007","volume":"43","author":[{"given":"Lars","family":"Haack","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Krug","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Severin","family":"Rodler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Nuhn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christof","family":"van der Horst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schulz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf","family":"Wittenstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Schmalz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Blanck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank-Andr\u00e9","family":"Siebert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Fabian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,9]]},"reference":[{"key":"5615_CR1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray F, Laversanne M, Sung H et al (2024) Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. 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DK has received honoraria from Astra Zeneca, best practice onkologie, ESO, ESMO, Gilead, med update, Merck Sharp & Dohme, Novartis, onkowissen, and Pfizer, as well as research funding from Stiftung Deutsche Krebshilfe and Merck KGaA. OW received honoraria and travel grants from Brainlab AG and novocure AG. SR has received honoraria from BMS, Merck, MSD and Novartis and has equity interest in Rocketlane Medical Ventures GmbH. All other authors declare no conflicts of interest. All other authors declare no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval was obtained from the local committee prior to enrolment of the first patient (Kiel, Germany D505\/23).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Written informed consent was obtained from each participating study patient.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}],"article-number":"220"}}