Litwin M S, Shpall A I, Dorey F, Nguyen T H
Department of Urology, School of Medicine, University of California, Los Angeles 90095-1738, USA.
Am J Clin Oncol. 1998 Aug;21(4):327-32. doi: 10.1097/00000421-199808000-00002.
The authors evaluate the temporal progression of health-related quality of life (HRQOL) in men treated hormonally with surgical or medical castration, as well as to see if either treatment would be associated with a greater impact on patients' quality of life. The authors assessed general and prostate-targeted HRQOL with two self-administered, validated instruments (the RAND 36-Item Health Survey and the UCLA Prostate Cancer Index) in a longitudinal, observational study of 63 men newly diagnosed with metastatic prostate cancer and treated with bilateral orchiectomy or combined androgen blockade with leuprolide and flutamide. Patients completed the two HRQOL instruments by mail at baseline and at 3- and 6-month intervals after initiation of treatment. Significant improvements were demonstrated in 10 of 14 HRQOL domains for all men during the first 12 months. These include all eight of the general HRQOL domains and the disease-specific domains that address bowel function. The authors identified no differences in any of the general or prostate-targeted HRQOL domains when comparing men who underwent orchiectomy versus combined androgen blockade. Patients with metastatic prostate cancer can be informed that general and prostate-specific HRQOL will be similar, regardless of whether they choose medical or surgical castration, and that health status will likely remain stable or improve during the initial months of treatment. Physicians must make patients aware of both the quantity and quality of life they can expect with advanced prostate cancer, and must actively involve them in their treatment decisions.
作者评估了接受手术去势或药物去势激素治疗的男性患者健康相关生活质量（HRQOL）的时间进展情况，同时探究这两种治疗方式对患者生活质量的影响是否存在差异。在一项针对63例新诊断为转移性前列腺癌并接受双侧睾丸切除术或亮丙瑞林与氟他胺联合雄激素阻断治疗的男性患者的纵向观察研究中，作者使用两种经过验证的自填式量表（兰德36项健康调查和加州大学洛杉矶分校前列腺癌指数）评估了总体和前列腺特异性HRQOL。患者在基线时以及治疗开始后的3个月和6个月通过邮寄方式完成这两种HRQOL量表。在最初的12个月内，所有男性患者的14个HRQOL领域中有10个领域显示出显著改善。这些领域包括所有8个总体HRQOL领域以及涉及肠道功能的疾病特异性领域。在比较接受睾丸切除术和联合雄激素阻断治疗的男性患者时，作者发现在任何总体或前列腺特异性HRQOL领域中均无差异。可以告知转移性前列腺癌患者，无论他们选择药物去势还是手术去势，总体和前列腺特异性HRQOL都将相似，并且在治疗的最初几个月内健康状况可能保持稳定或改善。医生必须让患者了解晚期前列腺癌患者预期的生活质量数量和质量，并必须积极让他们参与治疗决策。
