Chen Cheng, Chen Zhen, Wang Kun, Hu Linkun, Xu Renfang, He Xiaozhou
Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, P.R. China.
Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, P.R. China.
Oncotarget. 2017 Oct 5;8(58):99057-99065. doi: 10.18632/oncotarget.21519. eCollection 2017 Nov 17.
The objective of this study is to compare health-related quality of life (QOL) outcomes between radical prostatectomy (RP) and external beam radiation therapy (EBRT) for localized prostate cancer. PubMed, EMBASE, the Cochrane Library and Web of Science (to July 2017) were searched. Pooled analysis of each domain-specific score was calculated in relevant studies, and its change with follow-up time was explored by sub-group analysis. A total of six studies containing 4423 patients were included. Men underwent RP was associated with worse urinary and sexual domain score than EBRT (standardized mean difference (SMD) = -0.59, -0.58; 95% confidence interval (CI) = -0.73 to -0.45, -0.72 to -0.44). In contrast, EBRT group had lower bowel domain score than RP group (SMD = 0.42, 95% CI = 0.33 to 0.52). The sub-group analysis revealed the most severe urinary and sexual QOL in RP as well as bowel QOL in EBRT group all happened in the first month post operation. The different performance of two treatments in three QOL domains diminished afterwards. Health-related QOL should be considered comprehensively when planning follow-up for men after RP or EBRT for localized prostate cancer.
本研究的目的是比较根治性前列腺切除术（RP）和外照射放疗（EBRT）治疗局限性前列腺癌后的健康相关生活质量（QOL）结果。检索了PubMed、EMBASE、Cochrane图书馆和科学网（截至2017年7月）。在相关研究中计算每个特定领域评分的汇总分析，并通过亚组分析探讨其随随访时间的变化。共纳入六项研究，包含4423例患者。接受RP的男性在泌尿和性功能领域的评分比接受EBRT的男性更差（标准化均数差（SMD）=-0.59，-0.58；95%置信区间（CI）=-0.73至-0.45，-0.72至-0.44）。相比之下，EBRT组的肠道功能领域评分低于RP组（SMD=0.42，95%CI=0.33至0.52）。亚组分析显示，RP组中最严重的泌尿和性功能QOL以及EBRT组中最严重的肠道QOL均发生在术后第一个月。之后，两种治疗方法在三个QOL领域的不同表现有所减弱。在为局限性前列腺癌接受RP或EBRT治疗后的男性规划随访时，应综合考虑健康相关QOL。
