Dragićević Svetomir, Naumović Tamara, Soldatović Ivan, Mićić Sava, Tulić Cane, Pekmezović Tatjana
Urol Int. 2010;85(2):173-179. doi: 10.1159/000318187. Epub 2010 Jul 2.
The aims of this study were to evaluate the health-related quality of life (HRQOL) and make the treatment decision less difficult.
Between 2007 and 2009 radical retropubic prostatectomy (RRP) was performed in 96 patients and permanent prostate brachytherapy (PPB) in 88 patients at our hospital. The general and disease-specific HRQOL was measured using two instruments, the Medical Outcome Study 8-Item Short-Form Health Survey (SF-8) and the expanded prostate index composite (EPIC).
Comparing RRP and PPB, there were significant differences in all scores except for general health in the 1st month after treatment which had the same score in both groups. The baseline quality of life scores in physical function (p < 0.05), physical role (p < 0.01), social functioning (p < 0.01), emotional role (p < 0.01) and mental health (p < 0.01) showed significant differences between the group and were better in the PPB group than in the RRP group. The physical component summary score in the PPB group was better than in the RRP group in the 1st month (p < 0.01) but recovered up to 3 months in the RRP group. The urinary bother and irritative/obstructive scores in the 1st month were worse from baseline in both groups (p < 0.05) and remained significantly worse up to 6 months in the PPB group than in the RRP group where these scores recovered within 3 months. The urinary incontinence score in the RRP group was still worse than in the PPB group up to 12 months (p < 0.01). Bowel function and bother were significantly better in the RRP group at 3 (p < 0.05) and 6 months (p < 0.01) than in the PPB group where bowel function at 12 months was worse than at baseline and in the RRP group. Sexual function (p < 0.01) and sexual bother were better in the PPB group and did not change until 12 months.
The difference in disease-specific quality of life has become clearer using EPIC. As with other published studies, our results provide important information that will therefore be useful for selecting the optimal treatments for localized prostate cancer.
本研究旨在评估健康相关生活质量（HRQOL）并使治疗决策更易于做出。
2007年至2009年间，我院对96例患者实施了耻骨后根治性前列腺切除术（RRP），对88例患者实施了永久性前列腺近距离放射治疗（PPB）。使用两种工具，即医学结局研究8项简短健康调查（SF - 8）和扩展前列腺指数综合量表（EPIC）来测量一般和疾病特异性HRQOL。
比较RRP和PPB，除治疗后第1个月两组的一般健康得分相同外，其他所有得分均存在显著差异。两组在身体功能（p < 0.05）、身体角色（p < 0.01）、社会功能（p < 0.01）、情感角色（p < 0.01）和心理健康（p < 0.01）方面的基线生活质量得分存在显著差异，PPB组优于RRP组。PPB组的身体成分总结得分在第1个月优于RRP组（p < 0.01），但RRP组在3个月时恢复。两组第1个月的泌尿困扰和刺激/梗阻得分均较基线变差（p < 0.05），PPB组在6个月时仍显著差于RRP组，RRP组这些得分在3个月内恢复。RRP组的尿失禁得分在12个月时仍差于PPB组（p < 0.01）。RRP组在3个月（p < 0.05）和6个月（p < 0.01）时的肠道功能和困扰明显优于PPB组，PPB组12个月时的肠道功能比基线和RRP组更差。PPB组的性功能（p < 0.01）和性困扰更好，且直到12个月都没有变化。
使用EPIC后，疾病特异性生活质量的差异变得更加明显。与其他已发表的研究一样，我们的结果提供了重要信息，因此对于选择局限性前列腺癌的最佳治疗方法将是有用的。
