Health-related quality of life and pain in a real-world castration resistant prostate cancer population: results from the PRO-CAPRI-study in the Netherlands

Abstract Background To determine generic, cancer-specific and prostate cancer-specific health-related quality of life (HRQoL), pain and changes over time in metastatic castration-resistant prostate cancer (mCRPC) patients in daily practice. Patients and methods PRO-CAPRI is an observational, prospective study in 10 hospitals in the Netherlands. mCRPC patients completed EQ-5D, EORTC QLQ-C30, and BPI-SF three-monthly and EORTC QLQ-PR25 six-monthly for a maximum of two years. Subgroups were identified based on chemotherapy pretreatment. Outcomes were generic, cancer-specific and prostate cancer-specific HRQoL and self-reported pain. Descriptive statistics were performed including changes over time and minimal important differences (MID) between subgroups. Results In total, 151 included patients answered 873 questionnaires. Median follow-up from the start of study was 19.5 months and 84% were treated with at least one life-prolonging agent. Overall patients were in good clinical condition (ECOG 0-1 in 78%) with normal baseline haemoglobin, lactate dehydrogenase (LDH) and alkaline phosphatase (ALP). At inclusion, generic HRQoL was high with a mean EQ VAS of 73.2 out of 100. Lowest scores were reported on role and physical functioning (mean scores of 69 and 76 out of 100 respectively) with fatigue, pain, and insomnia were the most impaired domains. These domains deteriorated in >50% of patients. Conclusion Although most patients were treated with new treatments during follow-up, mCRPC has a negative impact on HRQoL with deterioration in all domains over time, especially role and physical functioning. These domains need specific attention during follow-up to maintain HRQoL as long as possible by timely start of adequate supportive care management.