Department of Urology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan.
Int J Urol. 2011 Dec;18(12):813-9. doi: 10.1111/j.1442-2042.2011.02866.x. Epub 2011 Oct 13.
To examine quality of life (QOL) for 3 years after radical retropubic prostatectomy (RRP) or permanent prostate brachytherapy (PPB) and to determine differences between the two procedures.
In all 107 patients who underwent RRP and 91 who received PPB between October 2005 and July 2007 were included in this study. QOL surveys were performed using the international prostate symptom score (IPSS), the Medical Outcome Study 8-items short form health survey and the expanded prostate cancer index composite at baseline and 1, 3, 6, 12 and 36 months after treatment.
At 3 years, all parameters for general QOL and almost all for disease-specific QOL were similar to those at 12 months. Urinary continence after RRP slightly improved from 12 months to 3 years, but it was still significantly worse than that after PPB. Scores for urinary irritation or obstruction and for bowel function and bother at 3 years were similar between the two groups. Sexual function and bother did not change between 12 months and 3 years in either group. Sexual function at 3 years after RRP was worse than that after PPB. Recovery from urinary incontinence and sexual function after RRP with nerve sparing were similar to those after PPB. Urinary incontinence at 3 years correlated with the treatment method and patients' age, whereas urinary irritation/obstruction and urinary bother correlated with the pre-treatment IPSS.
QOL assessment represents an important issue in prostate cancer management. Our findings are likely to be of aid in the development of a treatment plan for prostate cancer patients.
研究根治性前列腺切除术(RRP)或永久性前列腺近距离放射治疗(PPB)后 3 年的生活质量(QOL),并确定两种治疗方法之间的差异。
本研究纳入了 2005 年 10 月至 2007 年 7 月期间接受 RRP 和 PPB 的 107 例和 91 例患者。使用国际前列腺症状评分(IPSS)、医疗结果研究 8 项简明健康调查和扩展前列腺癌指数综合评分在基线、治疗后 1、3、6、12 和 36 个月时进行 QOL 调查。
3 年时,所有一般 QOL 指标和几乎所有疾病特异性 QOL 指标均与 12 个月时相似。RRP 后的尿控在 12 个月至 3 年间略有改善,但仍明显逊于 PPB。两组患者在 3 年时的尿路刺激或梗阻、肠道功能和不适评分相似。两组患者在 12 个月和 3 年时的性功能和不适均无变化。RRP 后 3 年的性功能较 PPB 差。RRP 伴神经保留术后的尿失禁和性功能恢复与 PPB 相似。RRP 后 3 年的尿失禁与治疗方法和患者年龄有关,而尿路刺激/梗阻和尿路不适与治疗前 IPSS 有关。
QOL 评估是前列腺癌管理的一个重要问题。我们的研究结果可能有助于制定前列腺癌患者的治疗计划。