{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:38:53Z","timestamp":1788514733749,"version":"build-2803163510"},"reference-count":29,"publisher":"Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:00:00Z","timestamp":1693353600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SJU"],"abstract":"<jats:p>Background: There are few studies utilizing the Expanded Prostate Index Composite questionnaire-26 (EPIC-26) questionnaire to examine the long-term association between Domain Summary Scores (DSSs) and Quality of Life (QoL) after External Beam Radiation Therapy (EBRT, 3DCRT [3D conventional radiotherapy]\/IMRT [intensity modulated radiation therapy]) versus EBRT combined with High-Dose-Rate Brachytherapy (BT+, 3DCRT [3D conventional radiotherapy]\/IMRT). In this cross-sectional study we compare long-term adverse effects and QoL after BT+ with EBRT.Methods: Prostate Cancer Survivors who at least 5 years previously, had undergone BT+ at Oslo University Hospital between 2004 and 2010 (n = 259) or EBRT (multicentre cohort) between 2009 and 2010 (n = 99) completed a questionnaire containing EPIC-26, Short Form-12 and questions regarding comorbidity\/social status. Results were presented as DSSs and Physical\/Mental Composite Scores of QoL (PCS\/MCS). Regression analyses explored firstly the associations between treatment modality and DSSs and secondly the impact of DSSs on QoL. We estimated the proportions of patients with big\/moderate problems. Clinical relevance was set according to the lowest limit of published Minimal Important Differences. P-values &lt;0.05 were considered statistically significant.Results: In multivariate analysis, only the urinary incontinence DSS remained statistically (P &lt; 0.05) and clinically significantly greater after BT+ than EBRT (90 vs. 83). The number of men with moderate\/big urinary or bowel problems was halved after BT+ (P &lt; 0.05). The number of patients with impaired PCS (score &lt; 45) were lower in the BT+ group than the EBRT group (P = 0.02). Regression analysis showed that decreasing levels of bowel and urinary irritation\/obstructive DSSs predicted worsening of PCS (P &lt; 0.001) and MCS (P = 0.007), respectively.Conclusions: Dose-escalated radiotherapy by BT did not negatively impact long-term adverse effects, substantial problems or QoL compared with EBRT. Future randomised studies using improved EBRT techniques are needed.<\/jats:p>","DOI":"10.2340\/sju.v58.9571","type":"journal-article","created":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T07:38:57Z","timestamp":1693381137000},"page":"68-75","source":"Crossref","is-referenced-by-count":5,"title":["External beam radiotherapy of prostate cancer with or without high dose-rate brachytherapy: the Norwegian experience with long-term urinary and bowel adverse effects"],"prefix":"10.2340","volume":"58","author":[{"given":"Trude B.","family":"Wedde","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milada C.","family":"Smaastuen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari","family":"Vatne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie Birthe","family":"Schulz-Jaavall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie D.","family":"Foss\u00e5","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang LH.","family":"Lilleby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2023,8,30]]},"reference":[{"key":"37714","doi-asserted-by":"crossref","unstructured":"Aus G, Abbou CC, Bolla M, Heidenreich A, Schmid HP, van Poppel H, et al. EAU guidelines on prostate cancer. Eur Urol. 2005;48(4):546\u201351. doi: 10.1016\/j.eururo.2005.06.001","DOI":"10.1016\/j.eururo.2005.06.001"},{"key":"37715","doi-asserted-by":"crossref","unstructured":"Hoskin PJ, Rojas AM, Bownes PJ, Lowe GJ, Ostler PJ, Bryant L. Randomised trial of external beam radiotherapy alone or combined with high-dose-rate brachytherapy boost for localised prostate cancer. Radiother Oncol. 2012;103(2):217\u201322. doi: 10.1016\/j.radonc.2012.01.007","DOI":"10.1016\/j.radonc.2012.01.007"},{"key":"37716","doi-asserted-by":"crossref","unstructured":"Kishan AU, Cook RR, Ciezki JP, Ross AE, Pomerantz MM, Nguyen PL, et al. Radical prostatectomy, external beam radiotherapy, or external beam radiotherapy with brachytherapy boost and disease progression and mortality in patients with gleason score 9\u201310 prostate cancer. JAMA. 2018;319(9):896\u2013905. doi: 10.1001\/jama.2018.0587","DOI":"10.1001\/jama.2018.0587"},{"key":"37717","doi-asserted-by":"crossref","unstructured":"Mottet N, van den Bergh RCN, Briers E, Van den Broeck T, Cumberbatch MG, De Santis M, et al. EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer-2020 update. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol. 2021;79(2):243\u201362. doi: 10.1016\/j.eururo.2020.09.042","DOI":"10.1016\/j.eururo.2020.09.042"},{"key":"37718","doi-asserted-by":"crossref","unstructured":"Aas K, Berge V, Myklebust T, Foss\u00e5 SD. Comparative survival outcomes of high-risk prostate cancer treated with radical prostatectomy or definitive radiotherapy regimens. Eur Urol Open Sci. 2021;26:55\u201363. doi: 10.1016\/j.euros.2021.01.011","DOI":"10.1016\/j.euros.2021.01.011"},{"key":"37719","doi-asserted-by":"crossref","unstructured":"Wedde TB, Smaastuen MC, Brabrand S, Foss\u00e5 SD, Kaasa S, Tafjord G, et al. Ten-year survival after high-dose-rate brachytherapy combined with external beam radiation therapy in high-risk prostate cancer: a comparison with the Norwegian SPCG-7 cohort. Radiother Oncol. 2019;132:211\u201317. doi: 10.1016\/j.radonc.2018.10.013","DOI":"10.1016\/j.radonc.2018.10.013"},{"key":"37720","doi-asserted-by":"crossref","unstructured":"Donovan JL, Hamdy FC, Lane JA, Mason M, Metcalfe C, Walsh E, et al. Patient-reported outcomes after monitoring, surgery, or radiotherapy for prostate cancer. N Engl J Med. 2016;375(15):1425\u201337. doi: 10.1056\/NEJMoa1606221","DOI":"10.1056\/NEJMoa1606221"},{"key":"37721","doi-asserted-by":"crossref","unstructured":"Dearnaley D, Griffin CL, Lewis R, Mayles P, Mayles H, Naismith OF, et al. Toxicity and patient-reported outcomes of a phase 2 randomized trial of prostate and pelvic lymph node versus prostate only radiotherapy in advanced localised prostate cancer (PIVOTAL). Int J Radiat Oncol Biol Phys. 2019;103(3):605\u201317. doi: 10.1016\/j.ijrobp.2018.10.003","DOI":"10.1016\/j.ijrobp.2018.10.003"},{"key":"37722","doi-asserted-by":"crossref","unstructured":"Catton CN, Lukka H, Gu CS, Martin JM, Supiot S, Chung PWM, et al. Randomized trial of a hypofractionated radiation regimen for the treatment of localized prostate cancer. J Clin Oncol. 2017;35(17):1884\u201390. doi: 10.1200\/JCO.2016.71.7397","DOI":"10.1200\/JCO.2016.71.7397"},{"key":"37723","doi-asserted-by":"crossref","unstructured":"Mohammed N, Kestin L, Ghilezan M, Krauss D, Vicini F, Brabbins D, et al. Comparison of acute and late toxicities for three modern high-dose radiation treatment techniques for localized prostate cancer. 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