Radiation Oncology, Cross Cancer Institute, Edmonton, AB.
Curr Oncol. 2012 Jun;19(3):e201-10. doi: 10.3747/co.19.915.
We examined the impact of hypofractionated radiation therapy and androgen suppression therapy (AST) on quality of life (QOL) in high-risk prostate cancer patients.
Between March 2005 and March 2007, 60 patients with high-risk prostate cancer were enrolled in a prospective phase ii study. All patients received 68 Gy (2.72 Gy per fraction) to the prostate gland and 45 Gy (1.8 Gy per fraction) to the pelvic lymph nodes in 25 fractions over 5 weeks. Of the 60 patients, 58 received ast. The University of California-Los Angeles Prostate Cancer Index questionnaire was used to prospectively measure QOL at baseline (month 0) and at 1, 6, 12, 18, 24, 30, and 36 months after radiation treatment. The generalized estimating equation approach was used to compare the QOL scores at 1, 6, 12, 18, 24, 30, and 36 months with those at baseline.
We observed a significant decrease in QOL items related to bowel and sexual function. Several QOL items related to bowel function were significantly adversely affected at both 1 and 6 months, with improvement toward 6 months. Although decreased QOL scores persisted beyond the 6-month mark, they began to re-approach baseline at the 18- to 24-month mark. Most sexual function items were significantly adversely affected at both 1 and 6 months, but the effects were not considered to be a problem by most patients. A complete return to baseline was not observed for either bowel or sexual function. Urinary function items remained largely unaffected, with overall urinary function being the only item adversely affected at 6 months, but not at 1 month. Urinary function returned to baseline and remained unimpaired from 18 months onwards.
In our study population, who received hypofractionated radiation delivered using dynamic intensity-modulated radiotherapy with inclusion of the pelvic lymph nodes, and 2-3 years of ast prescription, QOL with respect to bowel and sexual function was significantly affected; QOL with respect to urinary function was largely unaffected. Our results are comparable to those in other published studies.
我们研究了低分割放射治疗和雄激素抑制治疗（AST）对高危前列腺癌患者生活质量（QOL）的影响。
2005 年 3 月至 2007 年 3 月，我们纳入了 60 例高危前列腺癌患者进行前瞻性 II 期研究。所有患者接受前列腺 68 Gy（2.72 Gy/次）和盆腔淋巴结 45 Gy（1.8 Gy/次）的放射治疗，共 25 次，5 周完成。60 例患者中，58 例接受 AST。采用加利福尼亚大学洛杉矶前列腺癌指数问卷（UCLA-PI）前瞻性测量治疗后 1、6、12、18、24、30 和 36 个月的 QOL。采用广义估计方程（GEE）比较各时间点 QOL 评分与基线（0 个月）的差异。
我们观察到与肠道和性功能相关的 QOL 项目显著下降。几项与肠道功能相关的 QOL 项目在 1 个月和 6 个月时明显恶化，6 个月时开始改善。虽然 QOL 评分在 6 个月后持续下降，但在 18 至 24 个月时开始重新接近基线。大多数性功能项目在 1 个月和 6 个月时均受到显著影响，但大多数患者认为这些影响不是问题。肠道或性功能均未完全恢复至基线水平。尿功能项目基本不受影响，只有一项尿功能项目在 6 个月时受到不利影响，而 1 个月时无影响。尿功能在 18 个月后恢复至基线水平且未受影响。
在我们的研究人群中，采用动态调强放射治疗技术治疗高危前列腺癌，包括盆腔淋巴结，2-3 年 AST 治疗，QOL 中与肠道和性功能相关的项目显著受影响，与尿功能相关的项目基本不受影响。我们的结果与其他已发表的研究结果相当。
