Northwestern University, Chicago, IL, USA.
NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia.
Eur Urol Focus. 2019 Mar;5(2):144-146. doi: 10.1016/j.euf.2018.12.007. Epub 2019 Jan 3.
We review the importance of quality of life (QOL) data from patient-reported outcome measures (PROMs) among men treated with androgen deprivation therapy (ADT) for metastatic castration-sensitive prostate cancer (mCSPC) or localized prostate cancer treated with adjuvant therapy. This information is important for patients as they make treatment choices and for regulatory agencies approving drug therapies. Studies of treatments for mCSPC suggest that the improvements in survival associated with more intensive systemic treatment are accompanied by improvements in QOL. ADT prolongs survival among men with intermediate- or high-risk localized disease in combination with radiation, but the optimal duration is still being defined. For men with biochemical recurrence, starting ADT earlier rather than later had minimal adverse effects on QOL but may not prolong survival. We conclude that rigorous assessment of QOL with validated PROMs must be a priority for clinical trials of novel and more intensive approaches to treatment with ADT. PATIENT SUMMARY: Data on quality of life that are collected using patient-reported outcome measures are important for patients with prostate cancer as they make treatment choices and for regulatory agencies approving drug therapies.
我们回顾了接受雄激素剥夺治疗(ADT)的转移性去势敏感前列腺癌(mCSPC)或接受辅助治疗的局限性前列腺癌患者的报告结局指标(PROMs)中生活质量(QOL)数据的重要性。这些信息对患者在做出治疗选择以及监管机构批准药物治疗方面都非常重要。mCSPC 治疗研究表明,与更强化疗相关的生存改善伴随着 QOL 的改善。ADT 联合放疗可延长中危或高危局限性疾病男性的生存期,但最佳持续时间仍有待确定。对于生化复发的男性,尽早开始 ADT 而不是推迟,对 QOL 的负面影响最小,但可能不会延长生存期。我们得出结论,使用经过验证的 PROMs 对 QOL 进行严格评估必须成为 ADT 治疗新方法和更强化疗方法临床试验的优先事项。患者总结:使用患者报告结局指标收集的生活质量数据对前列腺癌患者在做出治疗选择以及监管机构批准药物治疗方面都非常重要。