种族对接受局部前列腺癌治疗的男性的治疗模式及随后的健康相关生活质量结果的影响。
The effect of race on treatment patterns and subsequent health-related quality of life outcomes in men undergoing treatment for localized prostate cancer.
机构信息
Virginia Mason Franciscan Health, Seattle, WA, USA.
Walter Reed National Military Medical Center, Bethesda, MD, USA.
出版信息
Prostate Cancer Prostatic Dis. 2023 Jun;26(2):415-420. doi: 10.1038/s41391-022-00608-4. Epub 2022 Nov 10.
INTRODUCTION
Racial differences in Health-Related Quality of Life (HRQoL) after treatment of prostate cancer (PCa) are not well studied. We compared treatment patterns and HRQoL in African American (AA) and non-AA men undergoing active surveillance (AS), radical prostatectomy (RP), or radiation (XRT).
METHODS
Men diagnosed with PCa from 2007-2017 in the Center for Prostate Disease Research Database were identified. HRQoL was evaluated using Expanded PCa Index Composite and SF-36 Health Survey.
RESULTS
In 1006 men with localized PCa, 223 (22.2%) were AA (mean follow up 5.2 yrs). AA men with low-risk disease were less likely to undergo AS (28.5 vs. 38.8%) and more likely to undergo XRT (22.3 vs. 10.6%) than non-AA men, p < 0.001. In intermediate-risk disease, AA received more XRT (43.0 vs. 26.9%) and less RP (50.5 vs 66.8%), p = 0.016. In all men, RP resulted in worse urinary function and sexual HRQoL compared to AS and XRT. Bowel HRQoL did not vary by treatment in AA men, however, in non-AA men, XRT resulted in worse bowel scores than AS and RP. HRQoL was then compared for each treatment modality. AA men had worse sexual bother (p = 0.024) after RP than non-AA men, No racial differences were found in urinary, bowel, hormonal, or SF-36 scores for men undergoing AS, RP or XRT.
CONCLUSION
AA men are less often treated with AS for low-risk disease and are more likely to undergo XRT. AA men experience worse sexual bother after RP, however, the effect of XRT on bowel symptoms is worse in non-AA men.
简介
种族差异对前列腺癌（PCa）治疗后的健康相关生活质量（HRQoL）的影响尚未得到充分研究。我们比较了非裔美国男性（AA）和非 AA 男性在接受主动监测（AS）、根治性前列腺切除术（RP）或放疗（XRT）治疗后的治疗模式和 HRQoL。
方法
从 2007 年至 2017 年，在前列腺疾病研究数据库中确定了诊断为 PCa 的男性。使用扩展前列腺癌指数综合评分和 SF-36 健康调查评估 HRQoL。
结果
在 1006 名局限性 PCa 男性中，223 名（22.2%）为 AA（平均随访 5.2 年）。低危疾病的 AA 男性接受 AS 的可能性较低（28.5%比 38.8%），接受 XRT 的可能性较高（22.3%比 10.6%），p < 0.001。在中危疾病中，AA 患者接受 XRT 的比例较高（43.0%比 26.9%），RP 比例较低（50.5%比 66.8%），p = 0.016。在所有男性中，RP 导致的尿功能和性 HRQoL 比 AS 和 XRT 差。AA 男性的肠道 HRQoL 不受治疗影响，但在非 AA 男性中，XRT 导致的肠道评分比 AS 和 RP 差。然后对每种治疗方式的 HRQoL 进行了比较。AA 男性在 RP 后出现更严重的性功能障碍（p = 0.024），而非 AA 男性则无此差异。在接受 AS、RP 或 XRT 治疗的男性中，未发现尿、肠、激素或 SF-36 评分的种族差异。
结论
AA 男性接受低危疾病 AS 治疗的可能性较低，而接受 XRT 的可能性较高。AA 男性在 RP 后出现更严重的性功能障碍，但 XRT 对非 AA 男性的肠道症状影响更严重。
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