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雄激素剥夺疗法对日本前列腺癌男性患者生活质量的影响。

Effect of androgen deprivation therapy on quality of life in Japanese men with prostate cancer.

作者信息

Kato Tomonori, Komiya Akira, Suzuki Hiroyoshi, Imamoto Takashi, Ueda Takeshi, Ichikawa Tomohiko

机构信息

Department of Urology, Chiba University, Graduate School of Medicine, Chiba, Japan.

出版信息

Int J Urol. 2007 May;14(5):416-21. doi: 10.1111/j.1442-2042.2007.01748.x.

Abstract

OBJECTIVE

We evaluated health-related quality of life (HRQOL) in Japanese men receiving androgen deprivation therapy (ADT) for prostate cancer.

METHODS

Fifty-six men were enrolled in this study. HRQOL was prospectively measured before ADT, and at 3, 6 and 12 months after treatment began, using a general (36-item Short-Form Health Survey) and disease-specific (the University of California, Los Angeles Prostate Cancer Index) HRQOL questionnaire.

RESULTS

In the general HRQOL questionnaire, patients with stage B (n = 22) or C (n = 17) disease showed a decline in vitality at 6 and 12 months (P < 0.05 for both). Stage D patients (n = 17) had improvements in bodily pain at 3 and 12 months (P < 0.05 for both), vitality at 12 months (P < 0.05), role-emotional at 6 months (P < 0.05), and mental health at 3 months (P < 0.05). When clinical stages were not considered, there were no significant changes in the 36-item Short-Form Health Survey. As for the disease-specific HRQOL, urinary function improved after ADT at 6 and 12 months (P < 0.05 for both), and urinary bother decreased at 3 (P < 0.05), 6 (P < 0.005) and 12 months (P < 0.05). Sexual function decreased at 3 (P < 0.05), 6 (P < 0.005) and 12 months (P < 0.005) but sexual bother improved at 6 and 12 months (P < 0.05 for both). If patients were stratified by clinical stages, similar findings were observed.

CONCLUSIONS

General HRQOL was mostly unaffected by ADT in Japanese men. Disease-specific questions indicated an increase in urinary function. Although deterioration of sexual function was marked, most patients did not report sexual bother. Our results shed new light on the impact of ADT on HRQOL and could provide useful information about patient-centered outcome evaluations.

摘要

目的

我们评估了接受雄激素剥夺疗法(ADT)治疗前列腺癌的日本男性的健康相关生活质量(HRQOL)。

方法

56名男性参与了本研究。使用通用的(36项简短健康调查)和特定疾病的(加利福尼亚大学洛杉矶分校前列腺癌指数)HRQOL问卷,在ADT治疗前以及治疗开始后的3、6和12个月对HRQOL进行前瞻性测量。

结果

在通用HRQOL问卷中,B期(n = 22)或C期(n = 17)疾病的患者在6个月和12个月时活力下降(两者P < 0.05)。D期患者(n = 17)在3个月和12个月时身体疼痛有所改善(两者P < 0.05),12个月时活力改善(P < 0.05),6个月时角色情感改善(P < 0.05),3个月时心理健康改善(P < 0.05)。当不考虑临床分期时,36项简短健康调查没有显著变化。至于特定疾病的HRQOL,ADT治疗后6个月和12个月时排尿功能改善(两者P < 0.05),3个月(P < 0.05)、6个月(P < 0.005)和12个月时排尿困扰减轻(P < 0.05)。性功能在3个月(P < 0.05)、6个月(P < 0.005)和12个月时下降(P < 0.005),但性困扰在6个月和12个月时改善(两者P < 0.05)。如果按临床分期对患者进行分层,观察到类似的结果。

结论

在日本男性中,通用HRQOL大多不受ADT影响。特定疾病问题表明排尿功能有所改善。虽然性功能恶化明显,但大多数患者未报告性困扰。我们的结果为ADT对HRQOL的影响提供了新的见解,并可为以患者为中心的结局评估提供有用信息。

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