Jønler M, Ritter M A, Brinkmann R, Messing E M, Rhodes P R, Bruskewitz R C
Division of Urology, University of Wisconsin, Madison.
Urology. 1994 Dec;44(6):876-82. doi: 10.1016/s0090-4295(94)80174-6.
To evaluate sequelae and estimate quality of life utilizing a survey instrument in 133 consecutive patients who have undergone definitive radiation therapy for localized prostate cancer.
All patients reported on have been followed for 14 to 60 months (median, 31 months) after radiation therapy and only patients with definitive prostate radiation therapy are included. Of the patients still alive at time of follow-up, 115 were mailed the questionnaire. Data regarding tumor grade and stage as well as treatment were extracted from patient files.
Of the 91% of patients who returned the questionnaire, 11% used a pad and 13% leaked more than a few drops of urine daily. Of all the respondents, 9% stated that incontinence was a problem, and 31% found urinary leaking significantly worsened after radiation therapy compared with before their diagnosis of prostate cancer. With respect to sexual function, 77% recalled being able to have full or partial erections prior to radiation therapy. At some time after radiation therapy, 22% of previously potent respondents were able to have a full erection and 41% were able to have a partial erection. Twenty-nine percent of all patients who were able to establish an erection prior to radiation therapy reported that impotence was a problem at the time of follow-up. Forty-nine percent of patients had abdominal pain, diarrhea, or abdominal cramping during or after radiation therapy and 31% of all patients still had some intestinal symptoms at the time of follow-up. Eighteen percent of all patients were significantly bothered by one or more of these bowel problems. Overall, 31% of all patients reported a persistent degree of physical discomfort that they believed was secondary to their prostate cancer or the effect of treatment. Eighty-one percent were satisfied with radiation therapy and 97% of the patients said they would have radiation therapy again if faced with the decision.
Utilizing a sensitive questionnaire on patients who had definitive radiation therapy for prostate cancer, we found the incidence of patients bothered by incontinence to be surprisingly frequent and higher than previously reported. The frequency of impotence is similar to previous studies. However, when our incontinence and impotence data were compared to Medicare patients who had undergone radical prostatectomy, the frequencies after radiation therapy were significantly lower. Despite the rates of sequelae, the patients were generally satisfied with the decision to undergo radiation therapy and with the medical treatment received.
使用一种调查工具评估133例接受局限性前列腺癌根治性放射治疗的连续患者的后遗症情况并估计其生活质量。
所有报告的患者在放射治疗后均已随访14至60个月（中位数为31个月），仅纳入接受前列腺根治性放射治疗的患者。在随访时仍存活的患者中，115例被邮寄了调查问卷。从患者病历中提取有关肿瘤分级、分期以及治疗的资料。
在返回问卷的91%的患者中，11%使用尿垫，13%每天漏尿超过几滴。在所有受访者中，9%表示尿失禁是一个问题，31%发现与前列腺癌诊断前相比，放射治疗后尿漏明显加重。关于性功能，77%回忆起在放射治疗前能够有完全或部分勃起。在放射治疗后的某个时间，22%之前有性功能的受访者能够有完全勃起，41%能够有部分勃起。在放射治疗前能够勃起的所有患者中，29%报告在随访时阳痿是一个问题。49%的患者在放射治疗期间或之后出现腹痛、腹泻或腹部绞痛，31%的所有患者在随访时仍有一些肠道症状。18%的所有患者受到一种或多种这些肠道问题的严重困扰。总体而言，31%的所有患者报告存在持续程度的身体不适，他们认为这是前列腺癌或治疗效果的继发结果。81%的患者对放射治疗满意，97%的患者表示如果面临同样的决定，他们会再次接受放射治疗。
通过对接受前列腺癌根治性放射治疗的患者使用一份敏感的调查问卷，我们发现受尿失禁困扰的患者发生率惊人地高，且高于先前报道。阳痿的发生率与先前研究相似。然而，当我们将尿失禁和阳痿数据与接受根治性前列腺切除术的医疗保险患者进行比较时，放射治疗后的发生率显著更低。尽管有后遗症发生率，但患者总体上对接受放射治疗的决定以及所接受的医疗治疗感到满意。
