Talcott J A, Rieker P, Clark J A, Propert K J, Weeks J C, Beard C J, Wishnow K I, Kaplan I, Loughlin K R, Richie J P, Kantoff P W
Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA, USA.
J Clin Oncol. 1998 Jan;16(1):275-83. doi: 10.1200/JCO.1998.16.1.275.
To assess complications of therapy for early (nonmetastatic) prostate cancer.
A prospective study of a cohort of 279 men who sought treatment advice and completed required pretreatment forms. The measures were self-reported patient symptoms and other measures of quality of life before therapy and at 3 and 12 months afterward.
Bowel and bladder symptoms were uncommon pretreatment. Patients frequently reported irritative bowel and bladder symptoms at 3 months after radiotherapy, although these subsided somewhat at 12 months. Substantial ("a lot") urinary incontinence and wearing of absorptive pads were reported by 11% and 35% at 12 months after surgery and varied little by age. Incontinence occurred after radiotherapy infrequently, and only in men more than 65 years old. Inadequate erections, present in one third of men pretreatment, were nearly universal at 3 months after surgery, although some improvement, primarily in men under 65 years of age, was evident at 12 months. Sexual dysfunction after radiotherapy increased less but continually through 12 months, suggesting that observed treatment-related differences would decline with further follow-up.
External-beam radiotherapy of early prostate cancer is followed by bowel and bladder irritability, by increasingly severe sexual dysfunction and, in men aged more than 65 years, occasional urinary incontinence. Greater sexual dysfunction and urinary incontinence occur in the year following radical prostatectomy. These postsurgical complication rates from patient questionnaires are greater than have been reported in other treatment series and confirm the results of two retrospective studies of patient-reported complications.
评估早期（非转移性）前列腺癌的治疗并发症。
对279名寻求治疗建议并填写所需预处理表格的男性进行前瞻性队列研究。测量指标为治疗前、治疗后3个月和12个月时患者自我报告的症状及其他生活质量指标。
肠道和膀胱症状在治疗前不常见。放疗后3个月患者常报告刺激性肠道和膀胱症状，不过这些症状在12个月时有所减轻。术后12个月时，分别有11%和35%的患者报告有大量尿失禁及使用吸收性尿垫的情况，且在各年龄组中差异不大。放疗后尿失禁很少见，且仅发生在65岁以上男性中。术前三分之一的男性存在勃起功能不足，术后3个月时几乎普遍存在，不过在12个月时主要是65岁以下男性有一些改善。放疗后性功能障碍增加较少，但持续至12个月，提示观察到的与治疗相关的差异会随着进一步随访而减小。
早期前列腺癌进行外照射放疗后会出现肠道和膀胱刺激症状、性功能障碍日益严重，且65岁以上男性会偶尔出现尿失禁。根治性前列腺切除术后的一年中会出现更严重的性功能障碍和尿失禁。患者问卷调查得出的这些术后并发症发生率高于其他治疗系列报道的结果，并证实了两项关于患者报告并发症的回顾性研究的结果。
