雄激素剥夺疗法对非转移性前列腺癌患者身体和认知功能以及生活质量的影响。

Impact of androgen deprivation therapy on physical and cognitive function, as well as quality of life of patients with nonmetastatic prostate cancer.

作者信息

Joly F, Alibhai S M H, Galica J, Park A, Yi Q-L, Wagner L, Tannock I F

机构信息

Department of Medical Oncology and Hematology, Princess Margaret Hospital, University of Toronto, 610 University Avenue, Toronto, Ontario, Canada.

出版信息

J Urol. 2006 Dec;176(6 Pt 1):2443-7. doi: 10.1016/j.juro.2006.07.151.

DOI:10.1016/j.juro.2006.07.151

PMID:17085125

Abstract

PURPOSE

Many patients with prostate cancer receive androgen deprivation therapy for long periods. We compared physical and cognitive function, and quality of life in a cross-sectional study of 57 patients receiving androgen deprivation therapy for nonmetastatic prostate cancer and 51 healthy age matched controls.

MATERIALS AND METHODS

Physical and daily function were measured by the 6-minute walk test, grip strength, the timed up and go test, and activities of daily living measures. Cognitive function was evaluated by the High Sensitivity Cognitive Screen and by a self-report prototype Functional Assessment of Cancer Therapy cognitive function subscale. Quality of life was assessed by the Functional Assessment of Cancer Therapy-General with the subscale for fatigue and by the Patient-Oriented Prostate Utility Scale.

RESULTS

Androgen deprivation therapy was given for a median of 1.8 years (range 0.4 to 7.4). Patients had lower median hemoglobin than controls (134 vs 148 gm/l, p <0.0001). Performance on physical tests was similar in the 2 groups. Moderate or severe cognitive impairment by the High Sensitivity Cognitive Screen was similar for patients (23%) and controls (35%, p = 0.2). Self-reported cognitive dysfunction was also similar. Scores for the Functional Assessment of Cancer Therapy-General were similar but the Patient Oriented Prostate Utility Scale summary score was worse for patients (median 71 vs 86, p <0.001). More patients reported severe fatigue (Functional Assessment of Cancer Therapy-Fatigue score less than 35, p = 0.03). Low energy, poor bladder control and loss of sexual function were reported in 36%, 47% and 95% of patients, and in 16%, 34% and 33% of controls, respectively.

CONCLUSIONS

Patients treated with androgen deprivation therapy experience more symptoms and have worse fatigue than controls, but this study did not detect any effect on physical or cognitive function.

摘要

目的

许多前列腺癌患者长期接受雄激素剥夺治疗。我们在一项横断面研究中，对57例接受非转移性前列腺癌雄激素剥夺治疗的患者和51例年龄匹配的健康对照者的身体和认知功能以及生活质量进行了比较。

材料与方法

通过6分钟步行试验、握力、计时起立行走试验和日常生活活动测量来评估身体和日常功能。通过高灵敏度认知筛查和癌症治疗功能评估认知功能子量表的自我报告原型来评估认知功能。通过癌症治疗功能评估通用量表的疲劳子量表和患者导向前列腺效用量表来评估生活质量。

结果

雄激素剥夺治疗的中位时间为1.8年（范围0.4至7.4年）。患者的血红蛋白中位数低于对照组（134 vs 148 g/L，p<0.0001）。两组在身体测试中的表现相似。高灵敏度认知筛查显示，患者（23%）和对照组（35%，p = 0.2）的中度或重度认知障碍相似。自我报告的认知功能障碍也相似。癌症治疗功能评估通用量表的得分相似，但患者导向前列腺效用量表的汇总得分对患者更差（中位数71 vs 86，p<0.001）。更多患者报告有严重疲劳（癌症治疗功能评估疲劳评分低于35，p = 0.03）。分别有36%、47%和95%的患者报告有精力不足、膀胱控制不佳和性功能丧失，而对照组分别为16%、34%和33%。