Department of Medicine, and Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Prostate Cancer Prostatic Dis. 2009;12(4):361-8. doi: 10.1038/pcan.2009.32. Epub 2009 Sep 1.
This study aims to examine and compare changes in quality of life after two common treatments for prostate cancer (PC), radical prostatectomy (RP) and radiation therapy (RT). Patients newly diagnosed with localized PC, scheduled to receive RP (n=68) or RT (n=66), completed three cancer/PC-specific psychometric instruments and three PC-specific utility instruments before treatment, and 2 and 12 months after treatment. We assessed the magnitude and time course of changes in psychometric and utility measures, and differences between treatments. The results showed that RP was associated with significant urinary and sexual dysfunction; RT caused bowel problems. Fatigue and pain were common to both. RP patients reported more problems with physical, role and social function. Utilities decreased significantly after both treatments. Effects were most severe 2 months post treatment, and then showed some recovery, but many endured for 1 year. After 1 year, 30-60% of patients had utility scores that were clinically significantly worse than at baseline. Secondary androgen deprivation therapy also significantly decreased psychometric and utility measures of quality of life. Many adverse symptoms reported 2 months after RP and RT endure for 1 year. Despite different symptom profiles, RP and RT result in similar utility decrements.
本研究旨在检查和比较两种常见前列腺癌（PC）治疗方法（根治性前列腺切除术[RP]和放射治疗[RT]）后生活质量的变化。新诊断为局限性 PC 的患者，计划接受 RP（n=68）或 RT（n=66）治疗，在治疗前、治疗后 2 个月和 12 个月分别完成了三种癌症/PC 特定的心理计量学工具和三种 PC 特定的效用工具。我们评估了心理计量学和效用测量变化的幅度和时间进程，以及治疗之间的差异。结果表明，RP 与明显的尿失禁和性功能障碍相关；RT 导致肠道问题。疲劳和疼痛对两者都很常见。RP 患者报告在身体、角色和社会功能方面有更多问题。两种治疗后，效用显著下降。治疗后 2 个月最严重，然后有所恢复，但许多人持续了 1 年。治疗 1 年后，30-60%的患者的效用评分明显低于基线。继发性雄激素剥夺治疗也显著降低了生活质量的心理计量学和效用测量。RP 和 RT 治疗后 2 个月报告的许多不良反应持续了 1 年。尽管症状谱不同，但 RP 和 RT 导致相似的效用降低。
