KEY POINTS
- REQUITE was a prospective international observational cohort of 1,760 men with non-metastatic prostate cancer treated with curative-intent external-beam radiotherapy and/or brachytherapy at 17 centres across Europe and the United States. Symptoms were assessed before treatment, acutely, and annually for up to eight years.
- At enrolment, 90% received external-beam radiotherapy without brachytherapy, 5.9% received external-beam radiotherapy with brachytherapy, and 4.5% received brachytherapy alone; 27% had undergone prostatectomy.
- The highest acute grade 2 or higher toxicity was urinary retention after brachytherapy: 27.8% with low-dose-rate brachytherapy alone and 30.1% with high-dose-rate brachytherapy used as a boost.
- Up to eight years, the highest grade 2 or higher late incidences were proctitis (12.1%) and haematuria (12.9%) after external-beam radiotherapy alone, and proctitis (6.4%) and urinary incontinence (32.4%) after prostatectomy plus external-beam radiotherapy.
- Grade 3 adverse-event incidence was generally below 1.5%, except for late urinary incontinence after prostatectomy plus external-beam radiotherapy (10.2%). Follow-up was available for 84% at two years but no more than 35% at any later time point.
CLINICAL TAKEAWAY
REQUITE provides prospective real-world benchmarks for gastrointestinal and genitourinary toxicity after contemporary prostate radiotherapy and may support patient counselling, prediction modelling, and biomarker research. It does not compare treatment strategies, and selective attrition substantially limits interpretation of the later time points, particularly beyond five years.