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Symptoms predicting health-related quality of life in prostate cancer patients treated with localized radiation therapy
  1. Chao-Pin Hsiao1,
  2. Mei-Kuang Chen2,
  3. Kathy J. Meyers1 and
  4. Leorey N. Saligan3
  1. 1. The Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
  2. 2. University of Arizona, 3009 E4th St. Tucson, AZ 85716, USA
  3. 3. National Institute of Nursing Research, Division of Intramural Research, National Institutes of Health, 9000 Rockville Pike, Building 3, Room 5E14, Bethesda, MD 20892, USA
  1. Corresponding Author: Chao-Pin Hsiao The Frances Payne Bolton School of Nursing, Case Western Reserve University, 2120 Cornell Road, Room 3120, Cleveland, OH 44106, USA Tel.: +1-216-3683343 Fax: +1-216-3683542 E-mail: cxh416{at}


Objective Patient-reported health-related quality-of-life (HRQOL) measures can provide guidance for treatment decision making, symptom management, and discharge planning. HRQOL is often influenced by the distress experienced by patients from disease or treatment-related symptoms. This study aimed to identify symptoms that can predict changes in HRQOL in men undergoing external beam radiation therapy (EBRT) for nonmetastatic prostate cancer (NMPC).

Methods Fifty-one men with NMPC scheduled for EBRT were assessed at the baseline, at the midpoint of EBRT, and at the end of EBRT. All participants received 38–42 daily doses of EBRT (five times a week), depending on the stage of their disease. Validated questionnaires were administered to evaluate depressive symptoms, urinary and sexual functions, bowel issues, symptom-related distress, fatigue, and HRQOL. Pearson correlations, repeated-measures ANOVA, and multiple regressions examined the relationships among variables.

Results Intensification of symptoms and increased symptom-related distress, with a corresponding decline in HRQOL, were observed during EBRT in men with NMPC. Changes in symptoms and symptom distress were associated with changes in HRQOL at the midpoint of EBRT (r=–0.37 to –0.6, P=0.05) and at the end of EBRT (r=–0.3 to –0.47, P=0.01) compared with the baseline. The regression model comprising age, body mass index, Gleason score, T category, androgen-deprivation therapy use, radiation dose received, symptoms (urinary/sexual/bowel problems, fatigue), and overall symptom distress explained 70% of the variance in predicting HRQOL. Urinary problems and fatigue significantly predicted the decline in HRQOL during EBRT.

Conclusion Identifying specific symptoms that can influence HRQOL during EBRT for NMPC can provide feasible interventional targets to improve treatment outcomes.

  • Symptoms
  • symptom distress
  • health-related quality of life
  • prostate cancer
  • radiation therapy

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See

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