The Effect of Salvage Radiotherapy and its Timing on the Health-related Quality of Life of Prostate Cancer Patients
The Effect of Salvage Radiotherapy and its Timing on the Health-related Quality of Life of Prostate Cancer Patients
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DOI：
10.1016/j.eururo.2016.03.010
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发表时间：
2016-11-01
期刊：
影响因子：
23.4
通讯作者：
van der Poel, Henk G.
中科院分区：
文献类型：
--
作者：
van Stam, Marie-Anne;Aaronson, Neil K.;van der Poel, Henk G.
背景资料：挽救性放疗（SRT）及其时机对前列腺癌患者健康相关生活质量（HRQoL）的影响尚不清楚。目的：比较接受SRT的患者与仅接受根治性前列腺切除术（RP）的患者的HRQoL，并调查SRT时机是否与HRQoL相关。设计、设置和参与者：所有SRT患者（n = 241）和所有仅RP患者（n = 1005）均选自前瞻性数据库（2004-2015）。结果测量和统计分析：混合效应生长模型调整了患者特征和基线HRQoL的显著差异，用于分析以下之间的关联：（1）“治疗”（仅RP与SRT）和（2）“SRT的时间”与HRQoL的变化。结果和局限性：SRT患者在最后一次治疗后，泌尿、肠道和勃起功能的恢复明显较差（p < 0.05）（泌尿和勃起功能的临床意义差异）。RP和SRT之间间隔时间较长（>= 7个月）的患者报告SRT后性满意度明显更好（p = 0.02），尿功能恢复更好（p = 0.03）。该研究的局限性包括非随机设计和变异的HRQoL measurement.Conclusions的时间：治疗后2年，SRT患者报告较差的HRQoL在几个HRQoL域相比，RP，只有患者，但不是在整体HRQoL。RP后延迟SRT的开始可能会限制泌尿和性问题的发生率和持续时间。尽管如此，关于SRT时间的决定也应该基于疾病复发的潜在好处。患者总结：手术后接受放疗的患者可能会遇到较差的泌尿，肠道和勃起功能相比，只接受手术的患者。虽然还需要更多的研究，但延迟放疗似乎限制了其对泌尿和性功能的影响。(C)2016年欧洲泌尿外科协会。Elsevier B. V.出版，保留所有权利。
Background: The impact of salvage radiotherapy (SRT) and its timing on health-related quality of life (HRQoL) in prostate cancer patients is still unclear.Objective: To compare the HRQoL of patients who underwent SRT with that of patients who underwent radical prostatectomy (RP) only and to investigate whether SRT timing is associated with HRQoL.Design, setting, and participants: All SRT patients (n = 241) and all RP-only patients (n = 1005) were selected from a prospective database (2004-2015). The database contained HRQoL and prostate problem assessments up to 2 yr after last treatment.Outcome measurement and statistical analysis: Mixed effects growth modelling adjusting for significant differences in patient characteristics and baseline HRQoL was used to analyze the association between: (1) "treatment'' (RP-only vs SRT) and (2) "timing of SRT'' with changes in HRQoL.Results and limitations: SRT patients showed significantly (p < 0.05) poorer recovery from urinary, bowel, and erectile function after their last treatment (clinically meaningful difference for urinary and erectile function). Patients with a longer interval (>= 7 mo) between RP and SRT reported significantly better sexual satisfaction after SRT (p = 0.02), and a better urinary function recovery (p = 0.03). Limitations of the study include the nonrandom design and the variability in timing of HRQoL measurements.Conclusions: Up to 2 yr after treatment, SRT patients reported poorer HRQoL in several HRQoL domains compared with RP-only patients, but not in overall HRQoL. Delaying the start of SRT after RP may limit the incidence and duration of urinary and sexual problems. Nevertheless, decisions regarding SRT timing should also be based on the potential benefits in disease recurrence.Patient summary: Patients who receive radiotherapy after surgery may experience poorer urinary, bowel, and erectile function compared with patients who undergo surgery only. Although more research is needed, delaying radiotherapy seems to limit its impact on urinary and sexual functioning. (C) 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.