EQUINOXE study: Impact of relational cohesion and sexuality on the quality of life of patients treated with gonadotropin-releasing hormone agonist for prostate cancer

Abstract

Objectives: To measure the effect of dyadic adjustment on changes in patients’ quality of life when initiating treatment with gonadotropin-releasing hormone (GnRH) agonist. Patients and methods: A prospective, multicenter, longitudinal, and non-interventional study (NCT02630641) that included patients with prostate cancer starting GnRH agonist therapy, and their partners, in 157 centers in France. Data were collected at inclusion and after 6 months of treatment on quality of life (WHOQOL-BREF), disease perception (B-IPQ), disease symptoms (QLQ-PR25), and perception of cohesion within the couple (dyadic adjustment, DAS-16). Results: The Full Analysis Set included 492 patients (median age [Q1;Q3]: 74 [68;80] years). An improvement of the quality of life (defined as the improvement of at least one of the four dimensions of WHOQOL-BREF) was reported in 290/434 (67%) patients between baseline and follow-up. Quality of life was better at baseline and follow-up in patients with good cohesion within the couple than in those with medium or poor cohesion. Factors associated with improvement in quality of life of patients were the following: initial presence of QLQ-PR25 hormonal treatment-related symptoms (OR [95% CI]: 3.00 [1.46, 6.17]) suggesting testosterone deficiency symptoms at baseline and initial low level (2.04 [1.12, 3.72]) or absence of sexual activity (2.23 [1.11, 4.50]) before GnRH agonist initiation. Conclusion: Men with the greatest improvement in quality of life after initiating hormone therapy were those with, at baseline, testosterone deficiency symptoms (identified by QLQ-PR25 treatment-related symptoms score) or no/low sexual activity. Cohesion within the couple was not confirmed as an influence on the evolution of quality of life.