Seymour Zachary A, Daignault-Newton Stephanie, McLaughlin P W, Sandler Howard, Jackson William, Johnson Skyler B, Miller David, Wei John, Sanda Martin, Hamstra Daniel A
Beaumont Health, Department of Radiation Oncology, Dearborn, MI, United States.
William Beaumont School of Medicine, Oakland University, Rochester, MI, United States.
Clin Transl Radiat Oncol. 2022 Jun 1;36:56-62. doi: 10.1016/j.ctro.2022.05.007. eCollection 2022 Sep.
OBJECTIVE/PURPOSE: Previously patient reported quality of life (QOL) was reported in men with prostate cancer a mean 2 and 6 years post treatment with open radical prostatectomy (RP), 3D conformal radiation therapy (3D CRT), or I low dose rate (LDR) brachytherapy (BT). Herein we update the results 15 years post-treatment QOL.
MATERIALS/METHODS: The Expanded Prostate Cancer Index (EPIC) domains were scored with differences evaluated at a median 15.8 years follow up based upon mean EPIC summary domains by ANOVA with pairwise post-hoc comparisons adjusted for age. Patient differences of current survey from first cross-section are reported as median change in summary score for each treatment group at median of 2.2 and 6.0, and 15.8 years.
Among men still alive response rate was 52% in BT, 60% in 3D CRT, and 62% in RP resulting in 30, 41, and 330 QOL questionnaires to evaluate for each corresponding modality at median follow up of 15.8 years. Men were a mean 75.3, 83.6, and 79.3 years of age after RP, 3DCRT, and BT, respectively.At a median of 15.8 years, there were largely persistent differences in EPIC domains without substantial evolution in QoL from middle time points. Persistent worsening in urinary irritative and bowel domain with 3DRT or BT compared to RP. Trend towards worse urinary incontinence with RP were noted without statistical differences within radiotherapy options.
As the EPIC patient reported outcomes with the longest follow-up, these data uniquely reveal temporal trends from 2 to 15 years post treatment. However, the treatment modalities of open RP, 3D CRT without image guidance or intensity modulation, and BT without peripheral loading or MRI guidance may not reflect modern techniques.
之前有研究报道了接受开放性根治性前列腺切除术（RP）、三维适形放疗（3D CRT）或低剂量率（LDR）近距离放疗（BT）治疗的前列腺癌男性患者在治疗后平均2年和6年的患者报告生活质量（QOL）。在此，我们更新了治疗后15年的QOL结果。
材料/方法：使用扩展前列腺癌指数（EPIC）领域评分，基于年龄调整的方差分析（ANOVA）和两两事后比较，在中位随访15.8年时评估平均EPIC总结领域的差异。将当前调查与首次横断面调查的患者差异报告为每个治疗组在2.2、6.0和15.8年中位数时总结评分的中位数变化。
在仍存活的男性中，BT组的应答率为52%，3D CRT组为60%，RP组为62%，在中位随访15.8年时，分别有30、41和330份QOL问卷用于评估每种相应的治疗方式。接受RP、3DCRT和BT治疗后，男性的平均年龄分别为75.3岁、83.6岁和79.3岁。在15.8年的中位数时，EPIC领域存在很大的持续差异，与中期时间点相比，QoL没有实质性演变。与RP相比，3DRT或BT治疗后，泌尿刺激性和肠道领域持续恶化。注意到RP治疗后尿失禁有恶化趋势，但在放疗选项中无统计学差异。
作为EPIC患者报告的随访时间最长的结果，这些数据独特地揭示了治疗后2至15年的时间趋势。然而，开放性RP、无图像引导或强度调制的3D CRT以及无外周加载或MRI引导的BT等治疗方式可能无法反映现代技术。
