Department of Radiation Oncology, Radboud University Medical Centre, PO Box 9101, Nijmegen, The Netherlands.
Br J Cancer. 2013 May 14;108(9):1784-9. doi: 10.1038/bjc.2013.181. Epub 2013 Apr 23.
Previous studies on the effects of different prostate cancer treatments on quality of life, were confounded because patients were not comparable. This study examined treatment effects in more comparable groups.
From 2008-2011, 240 patients with localised prostate cancer were selected to be eligible for both radical prostatectomy (RP) and external beam radiotherapy (EBRT). Brachytherapy (BT) was a third option for some. Health-related quality of life was measured by expanded prostate cancer index composite (EPIC) up to 12 months after treatment.
In the sexual domain, RP led to worse summary scores (P<0.001) and more often to a clinically relevant deterioration from baseline than BT and EBRT (79%, 33%, 34%, respectively). In the urinary domain, RP also led to worse summary scores (P=0.014), and more deterioration from baseline (41%, 12%, 19%, respectively). Only on the irritative/obstructive urinary scale, more BT patients (40%) showed a relevant deterioration than RP (17%) and EBRT patients (11%). In the bowel domain, the treatment effects did not differ.
This study provides a more unbiased comparison of treatment effects, as men were more comparable at baseline. Our results suggest that, for quality of life, radiotherapy is as least as good an option as RP for treating localised prostate cancer.
先前关于不同前列腺癌治疗方法对生活质量影响的研究受到了干扰，因为患者之间不具有可比性。本研究在更具可比性的组间检验了治疗效果。
2008 年至 2011 年，选择了 240 名局部前列腺癌患者，他们有资格接受根治性前列腺切除术（RP）和外部束放射治疗（EBRT）。对于一些患者，近距离放射治疗（BT）是第三种选择。通过扩展前列腺癌指数综合评分（EPIC），在治疗后 12 个月内测量与健康相关的生活质量。
在性领域，RP 导致更差的综合评分（P<0.001），并且比 BT 和 EBRT 更常出现从基线开始的临床相关恶化（分别为 79%、33%、34%）。在尿域，RP 也导致更差的综合评分（P=0.014），并且比基线恶化更多（分别为 41%、12%、19%）。只有在刺激性/阻塞性尿量表上，更多的 BT 患者（40%）出现相关恶化，而 RP（17%）和 EBRT 患者（11%）则没有。在肠域，治疗效果没有差异。
本研究提供了一种更公正的治疗效果比较，因为患者在基线时更具可比性。我们的结果表明，对于生活质量而言，放射治疗作为局部前列腺癌的治疗选择，与 RP 一样好。
