Quality of life during treatment with chemohormonal therapy: Analysis of E3805 chemohormonal androgen ablation randomized trial in prostate cancer

Alicia K. Morgans, Yu Hui Chen, Christopher J. Sweeney, David F. Jarrard, Elizabeth R. Plimack, Benjamin A. Gartrell, Michael A. Carducci, Maha Hussain, Jorge A. Garcia, David Cella, Robert S. DiPaola, Linda J. Patrick-Miller

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25 Scopus citations

Abstract

Purpose Chemohormonal therapy with docetaxel and androgen deprivation therapy (ADT+D) for metastatic hormone-sensitive prostate cancer improves overall survival as compared with androgen deprivation therapy (ADT) alone. We compared the quality of life (QOL) between patients with metastatic hormone-sensitive prostate cancer who were treated with ADT+D and those who were treated with ADT alone. Methods Men were randomly assigned to ADT+ D (six cycles) or to ADT alone. QOL was assessed by Functional Assessment of Cancer Therapy-Prostate (FACT-P), FACT-Taxane, Functional Assessment of Chronic Illness Therapy-Fatigue, and the Brief Pain Inventory at baseline and at 3, 6, 9, and 12 months. The Wilcoxon signed rank test was used to examine changes over time. Mixed-effect models compared the QOL between arms at each time point. Results Seven hundred ninety men were randomly assigned (ADT+D [n = 397] and ADT[ n = 393]) and completed FACT-P (90% at baseline, 86% at 3 months, 83% at 6 months, 78% at 9 months, and 77% at 12 months). ADT+D patients reported a statistically significant decline in FACT-P at 3 months (P, .001) but FACT-P did not differ significantly between baseline and 12 months (P = .38). ADT+D FACT-P scores were significantly lower at 3 months (P = .02) but significantly higher at 12 months (P = .04) when compared with ADT FACT-P scores. Differences did not exceed the minimal clinically important difference at any time point. ADT+D patients reported significantly lower Functional Assessment of Chronic Illness Therapy-Fatigue scores at 3 months than did ADT patients (P, .001). Over time, both arms reported significantly poorer FACT-Taxane scores (P, .001) when compared with baseline. Brief Pain Inventory scores were similar between arms. Conclusion Although ADT+D was associated with statistically worse QOL at 3 months, QOL was better at 12 months for ADT+D patients than for ADT patients. Both arms reported a similar minimally changed QOL over time, suggesting that ADT+D is not associated with a greater long-term negative impact on QOL.

Original languageEnglish (US)
Pages (from-to)1088-1095
Number of pages8
JournalJournal of Clinical Oncology
Volume36
Issue number11
DOIs
StatePublished - Apr 10 2018

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Morgans, A. K., Chen, Y. H., Sweeney, C. J., Jarrard, D. F., Plimack, E. R., Gartrell, B. A., Carducci, M. A., Hussain, M., Garcia, J. A., Cella, D., DiPaola, R. S., & Patrick-Miller, L. J. (2018). Quality of life during treatment with chemohormonal therapy: Analysis of E3805 chemohormonal androgen ablation randomized trial in prostate cancer. Journal of Clinical Oncology, 36(11), 1088-1095. https://doi.org/10.1200/JCO.2017.75.3335