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患者报告的结局和治疗相关并发症作为选择局限性前列腺癌治疗方案时的考虑因素。

Patient Reported Outcomes and Treatment-Associated Complications as a Consideration in Selecting Localized Prostate Cancer Management.

作者信息

Nguyen Tivoli, Lightfoot Christine, May David, Greenberg Jacob W, Krane Louis Spencer

机构信息

Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA.

Section of Urology, Southeast Louisiana Veterans Healthcare System, New Orleans, LA, USA.

出版信息

Res Rep Urol. 2025 Jun 12;17:195-210. doi: 10.2147/RRU.S386383. eCollection 2025.

DOI:10.2147/RRU.S386383
PMID:40528834
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12170866/
Abstract

Localized prostate cancer (PCa) remains the most common noncutaneous cancer in men, with numerous management options tailored to individual patient needs. This review examines the role of patient-reported outcomes (PROs) in guiding the management of localized PCa, focusing on the impact of various treatments on long-term quality of life. Standard therapies, including radical prostatectomy, radiotherapy, and active surveillance, are discussed alongside emerging focal therapies. Each treatment modality presents distinct risks, notably urinary incontinence, erectile dysfunction, bowel issues, and cancer recurrence. Understanding these adverse effects in terms of PROs is critical for patients and healthcare providers to engage in shared decision-making, enabling personalized treatment plans based on clinical outcomes and patient values. The incorporation of PROs into treatment selection emphasizes the significance of balancing oncologic control with functional outcomes, such as sexual, bowel, and urinary health. The importance of patient counseling is underscored, ensuring patients are fully informed about potential complications and long-term implications. This review advocates for personalized, evidence-based management strategies that align therapeutic decisions with individual patient preferences, optimizing both survival and quality of life. Enhanced communication between patients and clinicians, informed by PROs, is critical for minimizing decisional regret and maximizing satisfaction in the management of localized PCa.

摘要

局限性前列腺癌(PCa)仍然是男性中最常见的非皮肤癌,有多种根据个体患者需求定制的管理方案。本综述探讨了患者报告结局(PROs)在指导局限性PCa管理中的作用,重点关注各种治疗对长期生活质量的影响。除了新兴的聚焦治疗外,还讨论了包括根治性前列腺切除术、放疗和主动监测在内的标准疗法。每种治疗方式都有独特的风险,尤其是尿失禁、勃起功能障碍、肠道问题和癌症复发。从PROs的角度理解这些不良反应对于患者和医疗服务提供者进行共同决策至关重要,从而能够根据临床结果和患者价值观制定个性化的治疗方案。将PROs纳入治疗选择强调了在肿瘤控制与功能结局(如性健康、肠道健康和泌尿健康)之间取得平衡的重要性。强调了患者咨询的重要性,确保患者充分了解潜在的并发症和长期影响。本综述倡导个性化的、基于证据的管理策略,使治疗决策与个体患者偏好相一致,优化生存和生活质量。在PROs的指导下,加强患者与临床医生之间的沟通对于最大限度地减少决策遗憾和提高局限性PCa管理的满意度至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ec8/12170866/bdbb90de66b4/RRU-17-195-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ec8/12170866/bdbb90de66b4/RRU-17-195-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ec8/12170866/bdbb90de66b4/RRU-17-195-g0001.jpg

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本文引用的文献

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Long-Term Adverse Effects and Complications After Prostate Cancer Treatment.前列腺癌治疗后的长期不良反应和并发症
JAMA Oncol. 2024 Nov 7;10(12):1654-62. doi: 10.1001/jamaoncol.2024.4397.
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Patient-Reported Outcomes 12 Years after Localized Prostate Cancer Treatment.前列腺癌局部治疗 12 年后的患者报告结局。
NEJM Evid. 2023 Apr;2(4):EVIDoa2300018. doi: 10.1056/EVIDoa2300018. Epub 2023 Mar 11.
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Cancer statistics, 2024.2024年癌症统计数据。
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The Current Trend of Radiation Therapy for Patients with Localized Prostate Cancer.局限性前列腺癌放射治疗的现状。
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Prostate Cancer Review: Genetics, Diagnosis, Treatment Options, and Alternative Approaches.前列腺癌综述:遗传学、诊断、治疗选择和替代方法。
Molecules. 2022 Sep 5;27(17):5730. doi: 10.3390/molecules27175730.
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Five-Year Prospective Observational Study of African-American Men on Active Surveillance for Prostate Cancer Demonstrates Race Is Not Predictive of Oncologic Outcomes.五年前瞻性观察研究表明,非裔美国男性接受前列腺癌主动监测,种族与肿瘤学结果无关。
Oncologist. 2023 Feb 8;28(2):149-156. doi: 10.1093/oncolo/oyac154.
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Secondary bladder cancer during long-term follow-up after iodine-125 permanent seed implantation for localized prostate cancer.长期随访中前列腺癌碘-125 永久性种子植入术后继发膀胱癌。
Brachytherapy. 2022 Jul-Aug;21(4):451-459. doi: 10.1016/j.brachy.2022.03.001. Epub 2022 Apr 20.
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J Hematol Oncol. 2022 Mar 4;15(1):21. doi: 10.1186/s13045-022-01238-y.