{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T17:59:34Z","timestamp":1772128774902,"version":"3.50.1"},"reference-count":35,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: We assessed the changes in the quality of life (QOL) of patients with localized prostate cancer who were treated with IMRT, either with or without Androgen Deprivation Therapy (ADT), using the Expanded Prostate Index Composite (EPIC). Methods: Changes in EPIC summary and subdomain scores were evaluated using longitudinal analyses at eight time points up to three years after IMRT. Results: The urinary score and four subdomain scores decreased significantly four weeks after the start of IMRT but returned to the baseline level three months after IMRT. This pattern of change remained consistent, regardless of whether ADT was administered or not. The longitudinal changes in bowel score were the same as those in the urinary score. The recovery of the bowel bother subdomain score was rapid, occurring as early as one month after IMRT. Regardless of whether ADT was administered, there was no difference in longitudinal changes in bowel scores. The sexual score remained consistently low throughout the survey period, ranging from 33 to 35. The baseline score for the sexual bother subdomain was 94.44, but the score for the sexual function subdomain was extremely low at 8.24. The hormonal score at the start of IMRT was 87.37 but increased significantly at two and three years after IMRT. The hormonal bother subdomain score decreased significantly six months after IMRT initiation but subsequently increased, becoming significantly higher three years after IMRT. Conclusions: IMRT has made it possible to minimize deterioration in the quality of life of patients with localized prostate cancer by reducing adverse events.<\/jats:p>","DOI":"10.3390\/jcm15051780","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T16:57:13Z","timestamp":1772125033000},"page":"1780","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quality of Life in Japanese Men Treated with Intensity Modulated Radiotherapy for Localized Prostate Cancer: Three-Year Longitudinal Evaluation Using Patient-Reported Outcomes of the Expanded Prostate Index Composite (EPIC)"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0611-7093","authenticated-orcid":false,"given":"Norio","family":"Mitsuhashi","sequence":"first","affiliation":[{"name":"Department of Radiation Therapy, Hitachi, Ltd., Hitachinaka General Hospital, Hitachinaka City 312-0057, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Motegi","sequence":"additional","affiliation":[{"name":"Department of Radiation Therapy, Hitachi, Ltd., Hitachinaka General Hospital, Hitachinaka City 312-0057, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5987-4673","authenticated-orcid":false,"given":"Hajime","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Radiation Therapy, Hitachi, Ltd., Hitachinaka General Hospital, Hitachinaka City 312-0057, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshitaka","family":"Nemoto","sequence":"additional","affiliation":[{"name":"Department of Radiation Therapy, Hitachi, Ltd., Hitachinaka General Hospital, Hitachinaka City 312-0057, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daichi","family":"Tominaga","sequence":"additional","affiliation":[{"name":"Department of Radiation Therapy, Hitachi, Ltd., Hitachinaka General Hospital, Hitachinaka City 312-0057, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumiya","family":"Shiina","sequence":"additional","affiliation":[{"name":"Department of Radiation Therapy, Hitachi, Ltd., Hitachinaka General Hospital, Hitachinaka City 312-0057, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukiko","family":"Muto","sequence":"additional","affiliation":[{"name":"Department of Radiation Therapy, Hitachi, Ltd., Hitachinaka General Hospital, Hitachinaka City 312-0057, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiko","family":"Fukaya","sequence":"additional","affiliation":[{"name":"Department of Radiation Therapy, Hitachi, Ltd., Hitachinaka General Hospital, Hitachinaka City 312-0057, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Yamauchi","sequence":"additional","affiliation":[{"name":"Department of Urology, Hitachi, Ltd., Hitachinaka General Hospital, Hitachinaka City 312-0057, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinichi","family":"Yoshii","sequence":"additional","affiliation":[{"name":"Department of Urology, Hitachi, Ltd., Hitachinaka General Hospital, Hitachinaka City 312-0057, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"ref_1","unstructured":"(2025, October 03). Cancer Statistics in Japan 2025. Available online: https:\/\/ganjoho.jp\/reg_stat\/statistics\/stat\/summary.html."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1002\/cncr.11065","article-title":"Health Related Quality of Life in Prostate Carcinoma Patients: A Systematic Review of Randomized Controlled Trials","volume":"97","author":"Efficace","year":"2003","journal-title":"Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/S0090-4295(99)80325-2","article-title":"How is quality of life in prostate cancer patients influenced by modern treatment? The Wallenberg Symposium","volume":"49","author":"Altwein","year":"1997","journal-title":"Urology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1097\/00005650-199807000-00007","article-title":"The UCLA Prostate Cancer Index: Development, reliability, and validity of a health-related quality of life measure","volume":"36","author":"Litwin","year":"1998","journal-title":"Med. Cure"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/S0090-4295(00)00858-X","article-title":"Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer","volume":"56","author":"Wei","year":"2000","journal-title":"Urology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1856","DOI":"10.1016\/j.juro.2007.01.066","article-title":"Health related quality of life in Japanese men with localized prostate cancer treated with current multiple modalities assessed by a newly developed Japanese version of the Expanded Prostate Cancer Index Composite","volume":"177","author":"Kakehi","year":"2007","journal-title":"J. Urol."},{"key":"ref_7","first-page":"7599","article-title":"A systematic review of expanded prostate cancer index composite (EPIC) quality of life after surgery or radiation treatment","volume":"22","author":"Lee","year":"2015","journal-title":"Can. J. Urol."},{"key":"ref_8","first-page":"56","article-title":"Patients reported outcomes for quality of life (QOL) by Expanded Prostate Cancer Index (EPIC) on average 15 years post treatment","volume":"36","author":"Seymour","year":"2022","journal-title":"Clin. Transl. Radiat. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1002\/cncr.10651","article-title":"Mental hhealth in men treated for early stage prostate carcinoma: A postteatment, longitudinal quality of life analysis from the Cancer of the Prostate Strategic Urologic Research Endeavor","volume":"95","author":"Litwin","year":"2002","journal-title":"Cancer"},{"key":"ref_10","first-page":"e1668","article-title":"Stereotactic Body Radiotherapy for Low-Risk Prostate Cancer: A Ten-Year Analysis","volume":"9","author":"Katz","year":"2017","journal-title":"Cureus"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"7925","DOI":"10.1002\/cam4.3414","article-title":"Comparing bowel and urinary domains of patient-reported quality of life at the end of and 3 months post radiotherapy between intensity-modulated radiotherapy and proton beam therapy for clinically localized prostate cancer","volume":"9","author":"Bai","year":"2020","journal-title":"Cancer Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s12955-018-0859-1","article-title":"The German version of the Expanded Prostate Cancer Index Composite (EPIC): Translation, validation and minimal important difference estimation","volume":"16","author":"Umbehr","year":"2018","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1186\/s12955-019-1214-x","article-title":"Validation of the Italian version of the abbreviated expanded prostate cancer index composite (EPIC-26) in men with prostate cancer","volume":"17","author":"Marzorati","year":"2019","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"151","DOI":"10.2340\/sju.v60.44371","article-title":"Cross-cultural adaptation and psychometric validation of the Finnish version of the Expanded Prostate Cancer Index Composite-26 for patients with localised prostate cancer","volume":"60","author":"Ettala","year":"2025","journal-title":"Scand. J. Urol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"68","DOI":"10.2340\/sju.v58.9571","article-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","volume":"58","author":"Wedde","year":"2023","journal-title":"Scand. J. Urol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1186\/s12955-021-01856-z","article-title":"Health-related quality of life in men with localized prostate cancer treated with radiotherapy: Validation of an abbreviated version of the Expanded Prostate Cancer Index Composite for Clinical Practice in Spain","volume":"19","author":"Zapatero","year":"2021","journal-title":"Health Qual Life Outcomes"},{"key":"ref_17","first-page":"657","article-title":"The Japanese translation and cultural adaptation of Expanded Prostate Cancer Index Composite (EPIC)","volume":"96","author":"Takegami","year":"2005","journal-title":"Nippon. Hinyokika Gakkai Zasshi"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/0360-3016(95)00060-C","article-title":"Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC)","volume":"31","author":"Cox","year":"1995","journal-title":"Int. J. Radiat. Oncol. Biol. Pthys"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1016\/j.eururo.2024.08.030","article-title":"Radical Prostatectomy Versus Stereotactic Radiotherapy for Clinically Localised Prostate Cancer: Results of the PACE-A Randomised Trial","volume":"86","author":"Yasar","year":"2024","journal-title":"Eur. Urol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1007\/s11136-013-0603-6","article-title":"Longitudinal change in health-related quality of life after intensity-modulated radiation monotherapy for clinically localized prostate cancer","volume":"23","author":"Yamamoto","year":"2014","journal-title":"Qual. Life Res."},{"key":"ref_21","first-page":"169","article-title":"Quality of life worsened the most severely in patients immediately after intensity-modulated radiotherapy for prostate cancer","volume":"10","author":"Nakai","year":"2018","journal-title":"Res. Rep. Urol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1016\/S1470-2045(15)00280-6","article-title":"Hypofractionated radiotherapy versus conventionally fractionated radiotherapy for patients with intermediate-risk localised prostate cancer: 2-year patient-reported outcomes of the randomised, non-inferiority, phase 3 CHHiP trial","volume":"16","author":"Wilkins","year":"2015","journal-title":"Lancet Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1093\/jjco\/hyu173","article-title":"Correlation between the change in the EPIC QOL scores and the dose-volume histogram parameters in high-dose-rate brachytherapy combined with hypofractionated external beam radiation therapy for prostate cancer","volume":"45","author":"Hashimoto","year":"2015","journal-title":"Jpn. J. Clin. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1093\/jjco\/hyaa027","article-title":"Health-related quality of life in Japanese patients with prostate cancer following proton beam therapy: An institutional cohort study","volume":"50","author":"Matsukawa","year":"2020","journal-title":"Jpn. J. Clin. Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1002\/cncr.28536","article-title":"Comparative effectiveness study of patient-reported outcomes after proton therapy or intensity-modulated radiotherapy for prostate cancer","volume":"120","author":"Hoppe","year":"2014","journal-title":"Cancer"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.radonc.2014.01.007","article-title":"Dose to the inferior rectum is strongly associated with patient reported bowel quality of life after radiation therapy for prostate cancer","volume":"110","author":"Stenmark","year":"2014","journal-title":"Radiother. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"122","DOI":"10.3857\/roj.2021.00388","article-title":"Dose-volume histogram parameters and patient-reported EPIV-Bowel domain in prostate cancer proton therapy","volume":"39","author":"Bluman","year":"2021","journal-title":"Radiat. Oncol. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"751","DOI":"10.5980\/jpnjurol1989.95.751","article-title":"Reference ranges of total serum and free testosterone in Japanese male adults","volume":"95","author":"Iwamoto","year":"2004","journal-title":"Jap. J. Urol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1001\/jama.2011.1333","article-title":"Prediction of erectile function following treatment for prostate cancer","volume":"306","author":"Alemozaffar","year":"2011","journal-title":"JAMA"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.ijrobp.2009.04.094","article-title":"Radiation dose-volume effects and the penile bulb","volume":"76","author":"Roach","year":"2010","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Seymour, Z.A., Pinkawa, M., Daignault-Newton, S., Bosch, W., Michalski, J.M., Gay, H., and Hamstra, D.A. (2023). A pooled long-term follow-up after radiotherapy for prostate cancer with and without a rectal hydrogel spacer: Impact of hydrogel on decline in sexual quality of life. Front. Oncol., 13.","DOI":"10.3389\/fonc.2023.1239104"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1007\/s11136-021-02940-z","article-title":"The expanded prostate cancer index composite short form (EPIC-26) for measuring health-related quality of life: Content analysis of patients\u2019 spontaneous comments written in survey margins","volume":"31","author":"Talvitie","year":"2022","journal-title":"Qual. Life Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1007\/s12094-017-1749-4","article-title":"Assessment of acute bowel function after radiotherapy for prostate cancer: Is it accurate enough?","volume":"20","author":"Bonet","year":"2018","journal-title":"Clin. Transl. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s00345-020-03097-z","article-title":"Determinants of self-reported functional status (EPIC-26) in prostate cancer patients prior to treatment","volume":"39","author":"Roth","year":"2021","journal-title":"World J. Urol."},{"key":"ref_35","first-page":"78","article-title":"Late Adverse Health Outcomes and Quality of Life after curative radiotherapy + long-term ADT in Prostate Cancer Survivors: Comparison with men from the general population","volume":"37","author":"Dahl","year":"2020","journal-title":"Clin. Transl. Radiat. Oncol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/5\/1780\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T17:03:10Z","timestamp":1772125390000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/5\/1780"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,26]]},"references-count":35,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jcm15051780"],"URL":"https:\/\/doi.org\/10.3390\/jcm15051780","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,26]]}}}