Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Jubileumskliniken, Sahlgrenska University Hospital, Gothenburg, Sweden.
Int J Oncol. 2015 Jan;46(1):381-8. doi: 10.3892/ijo.2014.2734. Epub 2014 Oct 29.
Effects on long-term health-related quality of life (HRQoL) were evaluated in patients treated for localized prostate cancer by two standard modalities: radical retropubic prostatectomy (RP) and external beam radiotherapy combined with a high-dose-rate brachytherapy boost (HDRBT-EBRT). The HRQoL data were compared with age-adjusted normative data. Men diagnosed with localized prostate cancer and treated with curative intent in Gothenburg, Sweden, 1988-1997 were included. HRQoL was measured in October 2000 using the EORTC QLQ-C30 and EORTC QLQ-PR25 questionnaires, with a response rate of 82% (n=347). No differences in patient characteristics were found between the two treatment groups, except regarding tumor stage and PSA recurrence at the time of the questionnaires. In the RP group, 42% had T1 and 6% had T3-4 tumors; corresponding proportions in the HDRBT-EBRT group were 29% and 13% (p=0.01). PSA recurrence was detected in 44% of RP patients and 9% of HDRBT-EBRT patients. In most domains, mean HRQoL scores were high and similar to the scores for the age-adjusted normative sample. However, patients reported better role and physical function compared to the normal population. We also observed more sleeping disturbances but less pain among patients than in the normal population. The disease-specific questionnaires showed statistically significant higher levels of bowel and urinary problems in the irradiated group than in the RP group, and the absolute difference between the groups was small and had minor clinical significance. We conclude that overall the general quality of life was rated high by the patients irrespective of curative treatment modality and in agreement with age-adjusted normative data. Statistically significant differences in bowel and urinary symptoms were found between the two treatment groups in favor of the RP group, but the clinical significance was small.
对接受两种标准治疗方式（根治性经直肠前列腺切除术（RP）和外照射放疗联合高剂量率近距离放疗（HDRBT-EBRT））治疗局限性前列腺癌的患者的长期健康相关生活质量（HRQoL）影响进行了评估。将 HRQoL 数据与年龄调整的规范数据进行了比较。纳入了在瑞典哥德堡接受根治性治疗的局限性前列腺癌患者。在 2000 年 10 月，使用 EORTC QLQ-C30 和 EORTC QLQ-PR25 问卷进行了 HRQoL 测量，应答率为 82%（n=347）。两组患者的特征除了肿瘤分期和问卷调查时 PSA 复发外，没有差异。在 RP 组中，42%的患者为 T1 期，6%的患者为 T3-4 期；HDRBT-EBRT 组的相应比例分别为 29%和 13%（p=0.01）。RP 组中 44%的患者和 HDRBT-EBRT 组中 9%的患者检测到 PSA 复发。在大多数领域，平均 HRQoL 评分较高，与年龄调整的规范样本相似。然而，患者报告的角色功能和身体功能比普通人群要好。我们还观察到患者的睡眠障碍比普通人群少，但疼痛更多。与 RP 组相比，放射组的疾病特异性问卷显示出更高的肠和尿问题水平，且两组之间的绝对差异较小，具有较小的临床意义。我们的结论是，无论治疗方式如何，患者总体上对生活质量的评价都很高，与年龄调整的规范数据一致。在两种治疗方式中，放射组的肠和尿症状存在统计学上的显著差异，但临床意义较小。
