Wahlgren Thomas, Brandberg Yvonne, Häggarth Lars, Hellström Magnus, Nilsson Sten
Department of Oncology-Pathology, Radiumhemmet, Karolinska Institutet, S-17176 Stockholm, Sweden.
Int J Radiat Oncol Biol Phys. 2004 Sep 1;60(1):51-9. doi: 10.1016/j.ijrobp.2004.02.004.
To describe prospectively the long-term health-related quality of life (HRQOL) and treatment-related symptoms in patients with localized prostate cancer treated with neoadjuvant androgen deprivation therapy and radical radiotherapy (RT), including external beam RT and iridium high-dose-rate brachytherapy, and to compare them with age-matched normative data.
A total of 93 patients with T1-T3a tumors consecutively treated with definitive RT at our institution completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ)-C30 and QLQ-prostate specific 25-item (PR25) module twice at an 18-month interval 0-18 months after RT. Subgroups were analyzed regarding acute and late effects on symptoms and quality of life.
The main analysis included 80 patients who were disease free at the final assessment. The levels of HRQOL were generally high, did not change over time, and were comparable to the normative data. Symptom development (urinary, bowel, and sexual) correlated well with the known acute and late effects of radical RT and neoadjuvant androgen deprivation therapy.
Combining external beam RT and HDR brachytherapy when treating prostate cancer did not appear to impair HRQOL and was comparable to that of other brachytherapy methods. The negative contribution from late neoadjuvant androgen deprivation therapy on symptom development seemed to be substantial but mostly transitory. Additional research is needed to determine the long-term HRQOL (3-5 years), and interventional randomized studies are suggested.
前瞻性描述接受新辅助雄激素剥夺治疗和根治性放疗(RT)(包括外照射放疗和铱高剂量率近距离放疗)的局限性前列腺癌患者的长期健康相关生活质量(HRQOL)及治疗相关症状,并将其与年龄匹配的正常数据进行比较。
共有93例T1 - T3a期肿瘤患者在我们机构接受了根治性放疗,他们在放疗后0 - 18个月期间每隔18个月完成两次欧洲癌症研究与治疗组织生活质量问卷(QLQ)- C30和QLQ - 前列腺特异25项(PR25)模块。对亚组进行了关于症状和生活质量的急性和晚期影响的分析。
主要分析纳入了80例在最终评估时无疾病的患者。HRQOL水平总体较高,未随时间变化,且与正常数据相当。症状发展(泌尿、肠道和性功能方面)与根治性放疗和新辅助雄激素剥夺治疗已知的急性和晚期影响密切相关。
治疗前列腺癌时联合外照射放疗和高剂量率近距离放疗似乎并未损害HRQOL,且与其他近距离放疗方法相当。新辅助雄激素剥夺治疗晚期对症状发展的负面影响似乎很大,但大多是暂时的。需要进一步研究以确定长期(3 - 5年)的HRQOL,并建议进行干预性随机研究。