Meier Maria M, Koelbl Oliver, Gruber Isabella
University of Regensburg, Universitätsstraße 31, Regensburg, Germany.
Department of Radiation Oncology, University Hospital of Regensburg, Franz-Josef-Strauß Allee 11, Regensburg, Germany.
Sci Rep. 2024 Dec 31;14(1):32173. doi: 10.1038/s41598-024-84257-8.
There are concerns that radiotherapy for prostate cancer influences health-related quality of life in the long term. Furthermore, it is unclear whether postoperative radiotherapy is associated with a different quality of life due to a higher treatment burden compared to patients having received definitive radiotherapy for prostate cancer. This study enrolled 247 patients with localized or locally advanced prostate cancer who received external radiotherapy between 2011 and 2021. Health-related quality of life was assessed at a median of 63.6 months after radiotherapy using the European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30) with 145 patients returning questionnaires (response rate, 58.7%). Four patients treated with adjuvant radiotherapy were excluded due to the small number, resulting in 141 participants who received salvage radiotherapy (70 men) or definitive radiotherapy (71 men). The study compared the quality of life with age- and sex-matched German normative data. Patients completed the questionnaires after a median time of 60.3 and 65.2 months after salvage and definitive radiotherapy. The median patient age was higher in the definitive than in the salvage radiotherapy group (at radiotherapy, 72 vs. 69 years; at the survey, 79 vs. 75 years). Global health status, functional scales (physical, role, emotional, cognitive, and social), and symptom scales were not different between cancer patients of the same age group treated with salvage and definitive radiotherapy. The comparison with age- and sex-matched normative data revealed that salvage and definitive radiotherapy did not impair the global health status in patients of any age group. Physical functioning in patients < 70 years was significantly better in salvage and definitive radiotherapy groups compared to normative data while showing clinical relevance. Yet, social functioning was significantly lower in patients ≥ 70 years of the salvage radiotherapy group compared to normative data, while this difference lacked clinical significance. Regardless of the type of radiotherapy applied, cancer patients had no statistically or clinically relevant higher symptom burden compared to normative data. Quality of life was not clinically relevant influenced by radiotherapy, regardless of whether patients received salvage or definitive radiotherapy. Yet, longitudinal measurements of quality of life after radiotherapy are required to detect fluctuations in quality of life.
人们担心前列腺癌放疗会长期影响与健康相关的生活质量。此外，与接受前列腺癌根治性放疗的患者相比，术后放疗是否会因治疗负担更高而导致不同的生活质量尚不清楚。本研究纳入了247例2011年至2021年间接受外照射放疗的局限性或局部晚期前列腺癌患者。放疗后中位63.6个月时，使用欧洲癌症研究与治疗组织生活质量问卷（EORTC QLQ-C30）评估与健康相关的生活质量，145例患者返回问卷（回复率58.7%）。4例接受辅助放疗的患者因数量较少被排除，最终有141名参与者接受了挽救性放疗（70名男性）或根治性放疗（71名男性）。该研究将生活质量与年龄和性别匹配的德国标准数据进行了比较。患者在挽救性放疗和根治性放疗后中位60.3个月和65.2个月完成问卷。根治性放疗组患者的中位年龄高于挽救性放疗组（放疗时，72岁对69岁；调查时，79岁对75岁）。接受挽救性放疗和根治性放疗的同一年龄组癌症患者在总体健康状况、功能量表（身体、角色、情感、认知和社会）以及症状量表方面没有差异。与年龄和性别匹配的标准数据比较显示，挽救性放疗和根治性放疗均未损害任何年龄组患者的总体健康状况。年龄<70岁的患者在挽救性放疗组和根治性放疗组中的身体功能明显优于标准数据，同时具有临床相关性。然而，挽救性放疗组中年龄≥70岁的患者的社会功能明显低于标准数据，而这种差异缺乏临床意义。无论采用何种放疗类型，癌症患者与标准数据相比均无统计学或临床相关的更高症状负担。无论患者接受的是挽救性放疗还是根治性放疗，放疗对生活质量均无临床相关影响。然而，需要对放疗后的生活质量进行纵向测量，以检测生活质量的波动。
