Namiki Shunichi, Tochigi Tatsuo, Kuwahara Masaaki, Ioritani Naomasa, Terai Akito, Numata Isao, Satoh Makoto, Saito Seiichi, Koinuma Nobuo, Arai Yoichi
Department of Urology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan.
Int J Urol. 2004 Aug;11(8):619-27. doi: 10.1111/j.1442-2042.2004.00860.x.
We performed a retrospective survey of general and disease specific health-related quality of life (HRQOL) after radical prostatectomy (RP) and external beam radiotherapy (XRT) in Japanese men.
A total of 186 patients underwent RP and 78 underwent XRT for clinically localized prostate cancer between 2000 and 2002. We measured the general and disease specific HRQOL with the MOS 36-Item Health Survey and the University of California, Los Angeles Prostate Cancer Index, respectively. Each treatment group was further divided into four subgroups according to the time scale.
Patients from the RP group were significantly younger than those from the XRT group. The tumor characteristics differed significantly in their distributions among the treatment groups. Patients undergoing XRT had low scores in most of the general measures of HRQOL just after treatment, but after 6 months there were no differences between the treatment groups, except for the physical domains. The RP group was associated with worse urinary function, whereas the XRT group had worse bowel function and bother during the first 6 months after treatment. Thereafter, however, urinary and bowel domain did not differ between the groups. Both groups reported poor sexual function, although the RP group scored lower sexual bother.
The patients who underwent RP had significantly worse urinary and better bowel function than those treated with XRT. Both treatment groups had decrements in sexual function throughout the post-treatment period; careful attention should be paid to this side-effect in preoperative counselling, especially in younger patients, regardless of the primary treatments.
我们对日本男性在根治性前列腺切除术(RP)和外照射放疗(XRT)后一般及疾病特异性健康相关生活质量(HRQOL)进行了一项回顾性调查。
2000年至2002年间,共有186例患者接受了RP治疗,78例患者接受了XRT治疗,均为临床局限性前列腺癌。我们分别使用MOS 36项健康调查和加利福尼亚大学洛杉矶分校前列腺癌指数来测量一般及疾病特异性HRQOL。每个治疗组根据时间尺度进一步分为四个亚组。
RP组患者比XRT组患者明显年轻。肿瘤特征在各治疗组中的分布差异显著。接受XRT治疗的患者在治疗刚结束后,大多数一般HRQOL指标得分较低,但6个月后,除身体领域外,各治疗组之间没有差异。RP组与较差的排尿功能相关,而XRT组在治疗后的前6个月排便功能较差且困扰较多。然而,此后两组之间排尿和排便领域没有差异。两组患者的性功能均较差,尽管RP组在性困扰方面得分较低。
接受RP治疗的患者排尿功能比接受XRT治疗的患者明显更差,但排便功能更好。两个治疗组在整个治疗后期间性功能均有下降;在术前咨询中应特别关注这种副作用,尤其是在年轻患者中,无论主要治疗方式如何。