Health-related quality of life of exposed versus non-exposed androgen deprivation therapy patients with prostate cancer: a cross-sectional study
Background The survival rate of prostate cancer is relatively higher than other cancers, therefore, the health-related quality of life (HRQoL) becomes a critical issue for the patients. There are limited quality of life data evaluating the difference between androgen deprivation therapy and non-androgen deprivation therapy. Objective To evaluate the HRQoL among prostate cancer patients with androgen deprivation therapy and non-androgen deprivation therapy in an Asian population. Setting The study was conducted at the urology outpatient department in a medical center and a regional hospital in southern Taiwan. Methods We collected the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and Quality of Life Questionnaire-Prostate (QLQ-PR25) among prostate cancer patients with and without androgen deprivation therapy from December 2017 to June 2018. The androgen deprivation therapy subjects in this study were using goserelin, leuprolide, degarelix, bicalutamide, enzalutamide, cyproterone, and abiraterone. The non-androgen deprivation therapy subjects were only receiving radiation therapy or radical prostatectomy. To investigate the determinants of HRQoL between androgen deprivation therapy and non-androgen deprivation therapy, multiple linear regression was used. Main outcomes measures The scores of EORTC QLQ-C30 and QLQ-PR25. Results In total, 182 subjects participated in the study of which 116 (63.74%) were in androgen deprivation therapy user group with a mean age (± SD, standard deviation) of 75.94 years (± 8.31), and 66 (36.26%) subjects were in non-androgen deprivation therapy user group with a mean age of 70.6 years (± 7.1). androgen deprivation therapy users’ quality of life was significantly lower than non-androgen deprivation therapy users (72.1 ± 19.3 vs. 77.8 ± 16.6, p = 0.0493). Conclusions The quality of life of patients with all-stages prostate cancer differs significantly between androgen deprivation therapy users and non-androgen deprivation therapy users. The HRQoL for androgen deprivation therapy users is worse than for the non-androgen deprivation therapy users. Additionally, the symptoms are the key determinants of the quality of life.
KeywordsAndrogen deprivation therapy Prostate cancer Quality of life Radiation therapy Taiwan
We would like to thank the Center for Drug Evaluation and Ministry of Health and Welfare, Taiwan for supporting the program, and all the physicians who participated in this study. We also want to thank Dr. Tsu-Ming Chien for assistance in the writing of the study protocol.
This work was supported by a grant from the Center for Drug Evaluation and Ministry of Health and Welfare, Taiwan for supporting the program (RC1051116 and MOHW107-TDU-M-212-134005).
Conflicts of interest
The authors have no conflict of interest.
- 1.Ministry of Health and Welfare. Death statistics annual report. 2017. https://www.mohw.gov.tw/lp-3961-2.html. Accessed 23 July 2018.
- 2.Ministry of Health and Welfare. 2015 Taiwan Cancer Registry. https://www.hpa.gov.tw/EngPages/Detail.aspx?nodeid=1061&pid=6071. Accessed 29 Jan 2015.
- 3.National Cancer Institute. Cancer stat facts: prostate cancer. 2016; https://seer.cancer.gov/statfacts/html/prost.html (2018). Accessed 12 Jan 2018.
- 5.Chen RC, Basak R, Meyer AM, Kuo TM, Carpenter WR, Agans RP, et al. Association Between Choice of Radical Prostatectomy, External Beam Radiotherapy, Brachytherapy, or Active Surveillance and Patient-Reported Quality of Life Among Men With Localized Prostate Cancer. JAMA. 2017;317(11):1141–50.CrossRefGoogle Scholar
- 7.Cella DF. Measuring quality of life in palliative care. Semin Oncol. 1995;22(2 Suppl 3):73–81.Google Scholar
- 9.Shields AL, Hao Y, Krohe M, Yaworsky A, Mazar I, Foley C, et al. Patient-Reported Outcomes in Oncology Drug Labeling in the United States: A Framework for Navigating Early Challenges. Am Health Drug Benefits. 2016;9(4):188–97.Google Scholar
- 13.Murasawa H, Sugiyama T, Matsuoka Y, Okabe T, Hino A, Tanaka N, et al. Health utility and health-related quality of life of Japanese prostate cancer patients according to progression status measured using EQ-5D-5L and FACT-P. UQual Life Res. 2019. https://doi.org/10.1007/s11136-019-02184-y.Google Scholar
- 18.Fayers P, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bottomley A. EORTC QLQ-C30 scoring manual (3rd edition). European Organisation for Research and Treatment of Cancer; 2001.Google Scholar
- 20.Health Promotion Administration Ministry of Health and Welfare Taiwan. Cancer registry annual report, 2015 Taiwan. https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=269&pid=8084. Accessed 27 Dec 2017.
- 21.National Health Research Institutes. Guideline for clinical diagnosis and treatment of prostate cancer. 2010; 2010:120.Google Scholar
- 22.National Comprehensive Cancer Network. National Cancer Institute Cancer Stat Facts: Prostate Cancer (Version 2.2017). 2017; https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf. Accessed 8 Jan 2018.
- 29.Duchesne GM, Woo HH, King M, Bowe SJ, Stockler MR, Ames A, et al. Health-related quality of life for immediate versus delayed androgen-deprivation therapy in patients with asymptomatic, non-curable prostate cancer (TROG 03.06 and VCOG PR 01-03 [TOAD]): a randomised, multicentre, non-blinded, phase 3 trial. Lancet Oncol. 2017;18(9):1192–201.CrossRefGoogle Scholar