Hjälm-Eriksson Marie, Ullén Anders, Nilsson Sten, Johansson Hemming, Nilsson Josef, Castellanos Enrique, Brandberg Yvonne
Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Department of Surgery, Capio S:t Göran's Hospital, Stockholm, Sweden.
Acta Oncol. 2022 Oct;61(10):1179-1185. doi: 10.1080/0284186X.2022.2115314. Epub 2022 Sep 4.
The aim of this cross-sectional study was to investigate long-term health-related quality of life (HRQoL) in men with prostate cancer treated 2002-2008 with external beam radiotherapy (EBRT) combined with high dose-rate brachytherapy (HDRBT), Cohort A, and to compare these data with age-adjusted normative data. In addition, differences in HRQoL following adjustments of the brachytherapy technique in 2001 were investigated by comparing Cohort A with men treated at the same clinic from 1998-2000, Cohort B.
Cohort A: 1495 men treated with EBRT 2 Gy to 50 Gy and 2 fractions of 10 Gy HDRBT at a single centre, 2002-2008, still alive at five years. As part of routine follow-up, the patients responded to the EORTC QLQ-C30 and PR-25 questionnaires. Cohort B: HRQoL data was retrieved from an earlier study from the original article.
In Cohort A, 1046 (70%) men completed the questionnaires at five years, median age 66 years. In general, HRQoL mean scores were high and similar to Swedish age-matched normative data. Concerning disease-specific HRQoL, low levels of bowel and urinary problems were reported, in contrast to a substantial effect on sexual functioning. 'No' or 'A little' problems with faecal incontinence and urinary incontinence were reported by 98% and 93% of patients, respectively. The corresponding figure for sexual functioning was 39%. A difference in the frequency of nocturia in favour of Cohort A was the only statistically significant difference between Cohort A and B found in general and disease-specific HRQOL ( = 0.03), despite modifications in the brachytherapy procedure introduced in 2001.
Long-term general HRQoL was rated high and comparable to an aged-matched reference population five years after treatment with combined radiotherapy. Disease-specific HRQoL was still affected, foremost in the sexual domain.
本横断面研究旨在调查2002年至2008年接受外照射放疗（EBRT）联合高剂量率近距离放疗（HDRBT）治疗的前列腺癌男性患者（队列A）的长期健康相关生活质量（HRQoL），并将这些数据与年龄调整后的标准数据进行比较。此外，通过将队列A与1998年至2000年在同一诊所接受治疗的男性患者（队列B）进行比较，研究2001年近距离放疗技术调整后HRQoL的差异。
队列A：2002年至2008年在单一中心接受2 Gy至50 Gy EBRT和2次10 Gy HDRBT治疗且五年后仍存活的1495名男性。作为常规随访的一部分，患者对欧洲癌症研究与治疗组织（EORTC）QLQ-C30和PR-25问卷进行了回答。队列B：HRQoL数据取自原始文章的一项早期研究。
在队列A中，1046名（70%）男性在五年时完成了问卷，中位年龄为66岁。总体而言，HRQoL平均得分较高，与瑞典年龄匹配的标准数据相似。关于疾病特异性HRQoL，报告的肠道和泌尿系统问题水平较低，而对性功能有显著影响。分别有98%和93%的患者报告粪便失禁和尿失禁“无”或“有一点”问题。性功能方面的相应数字为39%。尽管2001年引入了近距离放疗程序的修改，但在总体和疾病特异性HRQOL方面，队列A和队列B之间发现的唯一具有统计学意义的差异是夜尿频率有利于队列A（P = 0.03）。
联合放疗治疗五年后，长期总体HRQoL评分较高，与年龄匹配的参考人群相当。疾病特异性HRQoL仍受到影响，主要在性功能领域。
