Pearce Andrew, Choo Richard, Danjoux Cyril, Morton Gerard, Loblaw D Andrew, Szumacher Ewa, Cheung Patrick, Deboer Gerrit, Chander Sarat
Department of Radiation Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada.
Int J Radiat Oncol Biol Phys. 2006 May 1;65(1):78-83. doi: 10.1016/j.ijrobp.2005.11.041. Epub 2006 Mar 24.
To examine the effect of salvage radiotherapy (RT) plus 2-year androgen suppression (AS) on quality of life (QOL).
A total of 74 patients with biopsy-proven local recurrence or PSA relapse after radical prostatectomy were treated with salvage RT plus 2-year AS, as per a phase II study. Quality of life was prospectively assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30-Item Version 3.0 with the added prostate cancer-specific module at baseline and predefined follow-up visits.
Patients experienced a significant increase in bowel dysfunction (23%) by the end of RT (p < 0.0001). This bowel dysfunction improved after RT but remained slightly elevated (5-10%) throughout the 2-year AS period. This extent of residual bowel dysfunction would be considered of minimal clinical importance. A similar, but less pronounced, pattern of change did occur for urinary dysfunction. Erectile function showed no change during RT, but had an abrupt decline (10%) with initiation of AS that was of moderate clinical significance (p < 0.01). None of the other QOL domains demonstrated a persistent, significant change from baseline that would be considered of major clinical significance.
The combined treatment with salvage RT plus 2-year AS had relatively minor long-term effects on QOL.
探讨挽救性放疗(RT)联合2年雄激素抑制(AS)对生活质量(QOL)的影响。
根据一项II期研究,共有74例经活检证实为前列腺癌根治术后局部复发或前列腺特异性抗原(PSA)复发的患者接受了挽救性RT联合2年AS治疗。在基线和预定的随访访视时,采用欧洲癌症研究与治疗组织生活质量问卷30项第3.0版并附加前列腺癌特异性模块对生活质量进行前瞻性评估。
放疗结束时,患者的肠道功能障碍显著增加(23%)(p<0.0001)。这种肠道功能障碍在放疗后有所改善,但在整个2年的AS治疗期间仍略有升高(5-10%)。这种残留肠道功能障碍的程度在临床上被认为具有最小的重要性。排尿功能障碍也出现了类似但不太明显的变化模式。勃起功能在放疗期间没有变化,但在开始AS治疗时突然下降(10%),具有中度临床意义(p<0.01)。其他生活质量领域均未显示出与基线相比有持续的、具有重大临床意义的显著变化。
挽救性RT联合2年AS的联合治疗对生活质量的长期影响相对较小。