Department of Nursing Sciences, Sophiahemmet University, Box 5606, 114 28, Stockholm, Sweden.
Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.
BMC Palliat Care. 2018 Dec 3;17(1):126. doi: 10.1186/s12904-018-0381-6.
Quality of Life (QoL) is the most important outcome for patients in palliative care along with symptom alleviation. Metastatic prostate cancer (mPC) is a life-threatening illness, and hence, a palliative care approach may be beneficial to this group. Over time, new life-prolonging treatments have been developed for men with mPC, but the possibility to prolong life should also be balanced against the men's QoL, particularly because there are side effects involved with these treatments. The aim of this study was to evaluate QoL, functioning and symptoms in men with mPC during their final years before death.
This is a retrospective analysis of data from a long-term prospective study of men (n = 3885) with prostate cancer from two regions in Sweden. Validated questionnaires asking about participants' QoL, functioning and symptoms were used to collect data. From the overall study, 190 men with mPC were identified. They were stratified into three groups, depending on the amount of time that had passed between the last questionnaire and their death; < 6 months, 6-18 months and > 18 months before death.
Men with mPC generally rated their QoL poorly compared to established clinically significant threshold values. The group of men that were < 6 months before death rated their QoL, functioning and several symptoms significantly worse than the two other groups. Men that died after the year 2006 reported lower QoL and functioning and more pain and fatigue than those who died before 2006.
The results in this study indicate that men with mPC have unmet needs with regards to QoL and symptoms. A palliative care approach, alongside possible life-prolonging treatments, that focuses on QoL and symptom relief, may serve as an important frame to give the best support to these men in their final years of life.
生活质量（QoL）是姑息治疗患者最重要的结果，同时也是症状缓解的结果。转移性前列腺癌（mPC）是一种危及生命的疾病，因此，姑息治疗方法可能对这一群体有益。随着时间的推移，已经为患有 mPC 的男性开发了新的延长生命的治疗方法，但延长生命的可能性也应该与男性的生活质量相平衡，特别是因为这些治疗方法存在副作用。本研究的目的是评估处于死亡前最后几年的 mPC 男性的生活质量、功能和症状。
这是对来自瑞典两个地区的前列腺癌男性（n = 3885）进行的长期前瞻性研究数据的回顾性分析。使用经过验证的问卷来收集有关参与者生活质量、功能和症状的信息。在整个研究中，确定了 190 名患有 mPC 的男性。他们根据最后一次问卷到死亡之间的时间长短分为三组：<6 个月、6-18 个月和>18 个月。
与既定的临床显著阈值相比，患有 mPC 的男性普遍对他们的生活质量评价较差。<6 个月前死亡的男性组在生活质量、功能和几个症状方面的评分明显比另外两组更差。与 2006 年前死亡的男性相比，2006 年后死亡的男性报告的生活质量和功能较低，疼痛和疲劳更多。
本研究的结果表明，患有 mPC 的男性在生活质量和症状方面存在未满足的需求。姑息治疗方法，结合可能的延长生命的治疗方法，重点关注生活质量和症状缓解，可能作为为这些男性在生命的最后几年提供最佳支持的重要框架。
