Ervandian Maria, Høyer Morten, Petersen Stine Elleberg, Sengeløv Lisa, Hansen Steinbjørn, Kempel Mette Moe, Meidahl Petersen Peter, Borre Michael
a Department of Urology , Aarhus University Hospital , Aarhus N , Denmark.
b Danish Center for Particle Therapy , Aarhus University Hospital , Aarhus C , Denmark.
Scand J Urol. 2017 Dec;51(6):457-463. doi: 10.1080/21681805.2017.1354314. Epub 2017 Jul 27.
There is a paucity of knowledge of long-term urinary morbidity in patients treated for prostate cancer (PCa) with radical prostatectomy (RP) and salvage radiotherapy (SRT). Improved long-term survival calls for heightened awareness of late effects from radiotherapy after RP. The purpose of this study was to assess late urinary morbidity and its potential impact on quality of life (QoL) in patients treated with RP plus SRT compared with patients treated with RP alone.
Long-term morbidity and QoL were evaluated using a cross-sectional design with validated questionnaires in urinary morbidity [Danish Prostatic Symptom Score (DAN-PSS)] and QoL [European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30)]. Included were a total of 227 patients treated with SRT and 192 treated with RP in the periods 2006-2010 and 2005-2007, respectively.
Weak stream, straining, frequency and nocturia were significantly more prevalent in patients treated with RP + SRT than in patients treated with RP alone. Patients treated with RP + SRT generally suffered from more severe urinary symptoms. The QoL scores of the two treatment groups were not statistically significantly different, but a high level of urinary morbidity was significantly related to decreased QoL (p = 0.000).
Patients treated with SRT have a higher rate of urinary morbidity than do patients treated with RP alone. Severe urinary morbidity was significantly related to decreased QoL, but did not differ between the two treatment groups.
对于接受根治性前列腺切除术（RP）和挽救性放疗（SRT）治疗的前列腺癌（PCa）患者，关于其长期泌尿系统发病情况的了解较少。长期生存率的提高要求人们提高对RP后放疗晚期效应的认识。本研究的目的是评估与单纯接受RP治疗的患者相比，接受RP加SRT治疗的患者的晚期泌尿系统发病率及其对生活质量（QoL）的潜在影响。
采用横断面设计，通过经过验证的泌尿系统发病率问卷[丹麦前列腺症状评分（DAN-PSS）]和生活质量问卷[欧洲癌症研究与治疗组织生活质量核心问卷30（EORTC QLQ-C30）]评估长期发病率和生活质量。纳入的患者共227例，分别于2006 - 2010年接受SRT治疗，192例于2005 - 2007年接受RP治疗。
与单纯接受RP治疗的患者相比，接受RP + SRT治疗的患者中，尿流无力、排尿费力、尿频和夜尿症更为普遍。接受RP + SRT治疗的患者一般泌尿系统症状更严重。两个治疗组的生活质量评分在统计学上无显著差异，但高水平的泌尿系统发病率与生活质量下降显著相关（p = 0.000）。
接受SRT治疗的患者泌尿系统发病率高于单纯接受RP治疗的患者。严重的泌尿系统发病率与生活质量下降显著相关，但两个治疗组之间无差异。
