Namiki Shunichi, Saito Seiichi, Tochigi Tatsuo, Kuwahara Masaaki, Ioritani Naomasa, Yoshimura Koji, Terai Akito, Koinuma Nobuo, Arai Yoichi
Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Int J Urol. 2005 Feb;12(2):173-81. doi: 10.1111/j.1442-2042.2005.01014.x.
We investigated the changes in health-related quality of life (HRQOL) in patients who underwent prostatectomy (RP) with or without neoadjuvant hormonal therapy (NHT).
A total of 72 patients undergoing direct RP (DRP group) and 26 patients receiving neoadjuvant hormonal therapy (NHT group) were enrolled in the present study. The baseline interview was conducted before RP (not initiation of therapy). Follow-up interviews were conducted in person at scheduled study visits of 3, 6, and 12 months after surgery. We measured general and disease specific HRQOL with the Medical Outcomes Study 36-Item Short Form and University of California, Los Angeles Prostate Cancer Index, respectively.
At baseline, the NHT group scored statistically lower for not only sexual function (P < 0.001), but also the general HRQOL, such as role limitations due to physical problems (P = 0.007), social function (P = 0.045) and mental health (P = 0.034), than the DRP group. The NHT group reported lower scores in social function and mental health at 3 months (P = 0.040 and 0.006, respectively). Patients who received NHT for more than 3 months continued to show significantly lower scores for some HRQOL domains 12 months later.
Neoadjuvant hormonal therapy may decrease not only sexual function, but also general HRQOL before surgery. The recovery of HRQOL appeared to be further prolonged in patients who received long-term NHT.
我们调查了接受或未接受新辅助激素治疗(NHT)的前列腺切除术(RP)患者健康相关生活质量(HRQOL)的变化。
本研究共纳入72例行直接前列腺切除术的患者(DRP组)和26例接受新辅助激素治疗的患者(NHT组)。基线访谈在RP术前(而非治疗开始时)进行。术后3、6和12个月的预定研究访视时进行面对面的随访访谈。我们分别使用医学结局研究36项简表和加利福尼亚大学洛杉矶分校前列腺癌指数来测量一般和疾病特异性HRQOL。
在基线时,NHT组不仅性功能得分在统计学上低于DRP组(P < 0.001),而且一般HRQOL得分也较低,如因身体问题导致的角色限制(P = 0.007)、社会功能(P = 0.045)和心理健康(P = 0.034)。NHT组在术后3个月时社会功能和心理健康得分较低(分别为P = 0.040和0.006)。接受NHT超过3个月的患者在12个月后某些HRQOL领域的得分仍显著较低。
新辅助激素治疗不仅可能降低性功能,还可能降低手术前的一般HRQOL。接受长期NHT的患者HRQOL的恢复似乎进一步延长。