Quality of Life Benefits of Testicular Cancer Treatments

A new study raises questions about the quality of life benefits of radiation therapy in the treatment of testicular cancer, according to the July 15, 2002 issue of the International Journal of Radiation Oncology, Biology and Physics.

The standard treatment for Stage I seminoma, a common form of testicular cancer, is removal of the testicle followed by radiation therapy. Radiation therapy reduces the likelihood of recurrence by 15 percent, but does not improve survival. Using health utilities, researchers set out to assess the quality of life benefits associated with adjuvant radiation therapy in this setting.

In the study, 100 healthy men were interviewed using a utility assessment tool. Utilities (preferences) for five health states were measured using the standard gamble technique: (A) adjuvant radiation therapy with 5 percent recurrence risk, (B) recurrence after radiation therapy, salvaged with chemotherapy, (C) removal of the testicle alone with 20 percent recurrence risk, (D) recurrence after removal of the testicle alone, salvaged with radiation therapy and (E) recurrence after removal of the testicle alone, salvaged with chemotherapy.

Preferences were highest for nonrecurrent health states (A and C), and lowest for recurrences salvaged with chemotherapy (B and E). All differences in utilities between health states were significant, except between states A and C and B and E. Variability in utilities was not explained by the sociodemographic factors examined. These results suggest that healthy males do not value the 15 percent reduction in recurrence risk achievable with adjuvant radiation therapy. However, they do predict that an actual recurrence, especially one requiring salvage chemotherapy, will lead to a significant decline in the quality of life.

"The impact of radiation therapy on quality of life is dependent on how men feel about the trade-off between the fear and consequences of developing a salvageable recurrence versus the potential toxicity and inconvenience of treatment with up-front radiation," said June L. Chan, M.D., of the Department of Radiation Oncology at the University of Michigan Medical Center and lead author of the study. James A. Hayman, M.D., M.B.A., the senior author of this study and an expert in utilities and cost-effectiveness analyses, adds, "We now intend to use these utilities to further evaluate the cost-effectiveness of radiation therapy in this setting."

To arrange an interview with the lead author of the study, June L. Chan, M.D., or to obtain a copy of the study, please call Aislinn Raedy at (703) 227-0141 or e-mail her at [email protected]. For more information on ASTRO's 44th Annual Meeting scheduled for October 6-10, 2002, in New Orleans, please visit the Media Corner at www.astro.org/meetings.

The International Journal of Radiation Oncology, Biology and Physics is the official journal of the American Society for Therapeutic Radiology and Oncology. ASTRO is the largest radiation oncology society in the world, with 7,000 members who specialize in treating patients with radiation therapies. As a leading organization in radiation oncology, biology and physics, the Society's goals are to advance the scientific base of radiation therapy and to extend the benefits of radiation therapy to those with cancer and other diseases.