Litwin Mark S
David Geffen School of Medicine, School of Public Health, University of California, Los Angeles, California, USA.
Curr Opin Urol. 2003 Mar;13(2):153-6. doi: 10.1097/00042307-200303000-00011.
Patients with clinically localized prostate cancer often undergo multiple therapies during their disease trajectory, either as planned combinations or as salvage for recurrence. Most studies of health-related quality of life in men with prostate cancer have focused on those receiving one modality or another. This review summarizes the little that is known about health-related quality of life after multiple therapies.
Twelve articles are reviewed. One is more of historical interest at this time and sets the stage for the great prevalence of combination therapy with androgen ablation in men undergoing pelvic irradiation. Six deal with brachytherapy combined with external beam radiation therapy, androgen ablation, or both. Three address androgen ablation or radiation for biochemical recurrence. One presents outcomes following salvage radiation, and one summarizes results from patients undergoing salvage radiation or prostatectomy following primary treatment with the other.
Combination therapy for early stage prostate cancer confers many additional decrements in health-related quality of life that must be considered when making treatment decisions, especially given the minimal differences in survival between various approaches.
临床局限性前列腺癌患者在其疾病进程中常接受多种治疗，既可是计划好的联合治疗，也可是针对复发的挽救性治疗。大多数关于前列腺癌男性患者健康相关生活质量的研究都集中在接受单一治疗方式的患者身上。本综述总结了关于多种治疗后健康相关生活质量的已知的少量信息。
共综述了12篇文章。其中一篇目前更多是具有历史意义，为盆腔放疗男性患者中雄激素剥夺联合治疗的高流行率奠定了基础。6篇涉及近距离放疗联合外照射放疗、雄激素剥夺或两者皆有。3篇探讨了针对生化复发的雄激素剥夺或放疗。1篇介绍了挽救性放疗后的结果，1篇总结了在接受另一种主要治疗后接受挽救性放疗或前列腺切除术患者的结果。
早期前列腺癌的联合治疗会使健康相关生活质量出现许多额外下降，在做出治疗决策时必须予以考虑，尤其是鉴于各种治疗方法在生存率上的差异极小。
