Namiki Shunichi, Ishidoya Shigeto, Ito Akihiro, Tochigi Tatsuo, Numata Isao, Narazaki Kakutaro, Yamada Shogo, Takai Yoshihiro, Arai Yoichi
Department of Urology, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aoba-ku, Sendai 980-8574, Japan.
Jpn J Clin Oncol. 2009 Nov;39(11):732-8. doi: 10.1093/jjco/hyp086. Epub 2009 Aug 8.
We evaluated health-related quality of life (HRQOL) in patients with localized prostate cancer who underwent intensity-modulated radiation therapy (IMRT) or three-field conformal radiotherapy (3DCRT).
A total of 97 patients underwent 3DCRT and 36 underwent IMRT for localized prostate cancer between 2002 and 2004. We measured the general and disease-specific HRQOL with the Medical Outcomes Study 36-Item Health Survey and University of California, Los Angeles Prostate Cancer Index, respectively.
There were no significant differences in the pre-operative characteristics of the two groups. The patients in the 3DCRT group were more likely to receive hormonal therapy compared with the IMRT group before and after radiation therapy (P < 0.001 and P = 0.011, respectively). With regard to general HRQOL domains, both the 3DCRT and IMRT group scores showed no significant difference between baseline and any of the observation periods. At 60 months after treatment, the 3DCRT group had significantly worse bowel function and bother scores than baseline (both P < 0.001). On the other hand, there were no significant differences between the baseline and any of the post-treatment time periods in the IMRT group. In the 3DCRT group, sexual function remained substantially lower than the baseline level (P = 0.023). The IMRT group tended to show a decrease in sexual function, which was not statistically significant (P = 0.11).
IMRT can provide the possibility to deliver a high irradiation dose to the prostate with satisfactory functional outcomes for long-term periods.
我们评估了接受调强放射治疗(IMRT)或三野适形放射治疗(3DCRT)的局限性前列腺癌患者的健康相关生活质量(HRQOL)。
2002年至2004年间,共有97例患者接受了3DCRT治疗局限性前列腺癌,36例接受了IMRT治疗。我们分别使用医学结局研究36项健康调查和加利福尼亚大学洛杉矶分校前列腺癌指数来测量总体和疾病特异性HRQOL。
两组患者术前特征无显著差异。与IMRT组相比,3DCRT组患者在放疗前后接受激素治疗的可能性更大(分别为P < 0.001和P = 0.011)。关于总体HRQOL领域,3DCRT组和IMRT组的得分在基线和任何观察期之间均无显著差异。治疗后60个月,3DCRT组的肠道功能和困扰得分显著低于基线水平(均为P < 0.001)。另一方面,IMRT组在基线和任何治疗后时间段之间均无显著差异。在3DCRT组中,性功能仍显著低于基线水平(P = 0.023)。IMRT组性功能有下降趋势,但无统计学意义(P = 0.11)。
IMRT能够为长期向前列腺提供高照射剂量并获得满意的功能结局提供可能。