Robinson John W, Donnelly Bryan J, Coupland Kerry, Siever Jodi E, Saliken John C, Scott Cheryl, Brasher P M A, Ernst D Scott
Department of Oncology and Program in Clinical Psychology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
Urol Oncol. 2006 Nov-Dec;24(6):472-86. doi: 10.1016/j.urolonc.2006.03.007.
Previous research has raised concerns that although salvage cryosurgery may be an effective treatment to prevent the progression of prostate cancer after radiotherapy failure, the quality of life cost many be so severe as to prevent its acceptance as a viable treatment. The present study's purpose was to further the understanding of the quality of life outcomes of salvage cryosurgery.
A total of 46 men with locally recurrent prostate cancer after radiotherapy were recruited to participate in a prospective Phase II clinical trial using salvage cryosurgery. There were 2 questionnaires (i.e., the European Organization of Research and Treatment of Cancer QLQ C30 and the Prostate Cancer Index) administered before cryosurgery, and at 1.5, 3, 6, 12, 18, and 24 months after treatment.
Quality of life returned to preoperative levels by 24 months after cryosurgery in all domains, with the exception of urinary and sexual functioning. At 24 months, 29% of men reported urinary bother as a moderate-to-big problem, and 56% reported sexual bother as a moderate-to-big problem.
To our knowledge, this is the first study to evaluate prospectively men's quality of life for 2 years after salvage cryosurgery for locally recurrent prostate cancer after radiotherapy. Long-term impairments in quality of life appear to be limited to the sexual and urinary function domains. Overall quality of life appears to be high. These results support salvage cryosurgery as a viable treatment option.
先前的研究引发了人们的担忧，即尽管挽救性冷冻手术可能是预防放疗失败后前列腺癌进展的有效治疗方法，但生活质量代价可能非常严重，以至于无法被接受为一种可行的治疗方法。本研究的目的是进一步了解挽救性冷冻手术的生活质量结果。
共招募了46名放疗后局部复发性前列腺癌患者，参与一项使用挽救性冷冻手术的前瞻性II期临床试验。在冷冻手术前以及治疗后1.5、3、6、12、18和24个月进行了2份问卷调查（即欧洲癌症研究与治疗组织QLQ C30问卷和前列腺癌指数问卷）。
除泌尿和性功能外，冷冻手术后24个月时，所有领域的生活质量均恢复到术前水平。在24个月时，29%的男性报告泌尿问题为中度至严重问题，56%的男性报告性问题为中度至严重问题。
据我们所知，这是第一项前瞻性评估放疗后局部复发性前列腺癌患者接受挽救性冷冻手术后2年生活质量的研究。生活质量的长期损害似乎仅限于性功能和泌尿功能领域。总体生活质量似乎较高。这些结果支持挽救性冷冻手术作为一种可行的治疗选择。
