Yu Chao, Yao Jie, He Yujing, Huang Jianing, Chen Meiling, Qian Mingxia, Lou Dandi, Zhou Zhizhen, Chen Feng
Department of Urology, Ningbo Medical Center LiHuiLi Hospital, Ningbo University, Ningbo, China.
School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China.
Cancer Med. 2023 Sep;12(17):18176-18188. doi: 10.1002/cam4.6395. Epub 2023 Jul 30.
The health-related quality of life (HRQoL) of patients with localized prostate cancer (LPCa) after treatment mainly surgery and radiotherapy (RT) has received increasing attention. The aim of this study is to compare the HRQoL of LPCa after surgery and RT.
Web of Science, Embase, PubMed and Cochrane databases were searched after January 2000 to observe the HRQoL scores after surgery and RT at different treatment time points.
A total of 28 studies were included in this study, and the results showed that LPCa received surgery had better bowel scores than RT at ≤3 (weighted mean differences [WMD] = 4.18; p = 0.03), 3-6 (WMD = 4.16; p < 0.001), 6-12 (WMD = 2.99; p = 0.004), 24-60 (WMD = 1.87; p = 0.06), and ≥60 (WMD = 4.54; p = 0.02) months. However, LPCa received RT had higher urinary scores at ≤3 (WMD = -7.39; p = 0.02), 3-6 (WMD = -6.03; p = 0.02), 6-12 (WMD = -4.90; p < 0.001), 24-60 (WMD = -3.96; p < 0.001), ≥60 (WMD = -2.95; p < 0.001) months and had better sexual scores at ≤3 (WMD = -13.58; p = 0.09), 3-6 (WMD = -12.32; p = 0.06), 6-12 (WMD = -12.03; p = 0.002), 24-60 (WMD = -11.29; p < 0.001), and ≥60 (WMD = -3.10; p = 0.46) months than surgery. The scores difference between surgery and RT decreased over time.
Overall, for LPCa, surgery was associated with better HRQoL in the bowel domain, whereas RT was associated with better HRQoL in the urinary and sexual domains, with the difference between surgery and RT narrowing over time.
局限性前列腺癌（LPCa）患者经主要包括手术和放疗（RT）的治疗后的健康相关生活质量（HRQoL）受到了越来越多的关注。本研究的目的是比较手术和放疗后LPCa患者的HRQoL。
检索2000年1月以后的Web of Science、Embase、PubMed和Cochrane数据库，以观察手术和放疗后不同治疗时间点的HRQoL评分。
本研究共纳入28项研究，结果显示，接受手术的LPCa患者在≤3个月（加权平均差[WMD]=4.18；p=0.03）、3-6个月（WMD=4.16；p<0.001）、6-12个月（WMD=2.99；p=0.004）、24-60个月（WMD=1.87；p=0.06）和≥60个月（WMD=4.54；p=0.02）时肠道评分优于接受放疗的患者。然而，接受放疗的LPCa患者在≤3个月（WMD=-7.39；p=0.02）、3-6个月（WMD=-6.03；p=0.02）、6-12个月（WMD=-4.90；p<0.001）、24-60个月（WMD=-3.96；p<0.001）、≥60个月（WMD=-2.95；p<0.001）时尿功能评分高于接受手术的患者，且在≤3个月（WMD=-13.58；p=0.09）、3-6个月（WMD=-12.32；p=0.06）、6-12个月（WMD=-12.03；p=0.002）、24-60个月（WMD=-11.29；p<0.001）和≥60个月（WMD=-3.10；p=0.46）时性功能评分优于接受手术的患者。手术和放疗之间的评分差异随时间减小。
总体而言，对于LPCa患者，手术在肠道方面与更好的HRQoL相关，而放疗在泌尿和性功能方面与更好的HRQoL相关，手术和放疗之间的差异随时间缩小。
