Fransson Per
Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden.
Acta Oncol. 2008;47(5):852-61. doi: 10.1080/02841860701654325.
To prospectively examine the urinary toxicity and quality of life (QOL) in patients 15 years after external beam radiotherapy (EBRT) for localized prostate cancer (LPC) and compare the outcomes with results for age-matched controls.
Urinary symptoms were assessed using the symptom-specific Prostate Cancer Symptom Scale (PCSS) questionnaire, and QOL was assessed with the European Organization for Research and Treatment of Cancer (EORTC)'s Quality of Life Questionnaire (QLQ-C30). Both questionnaires were sent to the surviving 41 patients(25%) and the PCSS questionnaire was sent to 69 age-matched controls for comparison.
The response rate was 71% in the patient group and 59% in the control group. Two patients and four controls were excluded due to other cancer diagnoses, resulting in a total of 27 patients and 37 controls for inclusion in the analyses. The mean age in both groups was 78 years. In the patient group, incontinence had increased between the 8-year (mean 0.6) and the 15-year follow-up (mean 2.1; p0.038). No other differences in urinary problems were seen between these two follow-ups. Increased incontinence, stress incontinence, and pain while urinating were reported by the patients in comparison with the controls at 15 years. Role function was worse in the patient group (mean 67.3) compared with the controls (mean 82.4; p0.046). The patients also reported more appetite loss, diarrhea, nausea/vomiting, and pain than the controls.
EBRT for LPC has divergent effects on urinary symptoms and QOL in comparison with age-matched controls. In our patient population, urinary incontinence increased between 8 and 15 years of follow-up. Otherwise, no differences in urinary symptoms were seen between 4 and 15 years. Incontinence, stress incontinence, and pain while urinating were increased after EBRT in comparison with the controls. Conventional EBRT did not result in a major deterioration in QOL 15 years after treatment.
前瞻性研究局限性前列腺癌（LPC）患者接受体外放射治疗（EBRT）15年后的泌尿毒性和生活质量（QOL），并将结果与年龄匹配的对照组进行比较。
使用症状特异性前列腺癌症状量表（PCSS）问卷评估泌尿症状，并用欧洲癌症研究与治疗组织（EORTC）的生活质量问卷（QLQ-C30）评估生活质量。两份问卷分别发送给41名存活患者（25%），并将PCSS问卷发送给69名年龄匹配的对照者进行比较。
患者组的回复率为71%，对照组为59%。由于其他癌症诊断，排除了2名患者和4名对照者，最终共有27名患者和37名对照者纳入分析。两组的平均年龄均为78岁。在患者组中，尿失禁在8年随访（平均0.6）至15年随访期间有所增加（平均2.1；p<0.038）。在这两次随访之间，未发现其他泌尿问题有差异。与15年时的对照组相比，患者报告尿失禁、压力性尿失禁和排尿时疼痛增加。与对照组（平均82.4；p<0.046）相比，患者组的角色功能较差（平均67.3）。患者还报告比对照组有更多的食欲减退、腹泻、恶心/呕吐和疼痛。
与年龄匹配的对照组相比，LPC的EBRT对泌尿症状和生活质量有不同影响。在我们的患者群体中，尿失禁在随访8至15年期间有所增加。否则，在4至15年之间未发现泌尿症状有差异。与对照组相比，EBRT后尿失禁、压力性尿失禁和排尿时疼痛增加。传统EBRT在治疗15年后并未导致生活质量严重恶化。
