Patient-reported quality of life during radiation treatment for localized prostate cancer: results from a prospective phase II trial
Patient-reported quality of life during radiation treatment for localized prostate cancer: results from a prospective phase II trial
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DOI：
10.1111/j.1464-410x.2012.11117.x
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发表时间：
2012-12-01
影响因子：
4.5
通讯作者：
D'Amico, Anthony V.
中科院分区：
文献类型：
--
作者：
Chen, Ronald C.;Zhang, Yuanye;D'Amico, Anthony V.
目的评估从II期试验收集的数据，以描述前列腺癌放射治疗(RT)期间患者报告的急性泌尿和肠道症状发展的时间进程和轨迹。患者和方法总共100名中高危前列腺癌患者接受了72GY的前列腺和精囊放射治疗，同时接受6个月的雄激素去除治疗；直肠气囊用于前列腺固定。患者每12周完成一次前列腺癌症状指数问卷调查，按4分或5分Likert量表报告尿路和肠道症状。症状评分=3与临床有意义的痛苦相关。每种症状的累积发生率都有报告。P值的Bonferroni校正被用来调整多次比较。结果尿路症状在基线时经常出现，并在治疗期间恶化。到RT结束时，2850%的患者出现了临床上有意义的梗阻和刺激性尿路症状。急性肠道症状较少出现。从放疗开始到放疗结束，每个肠道症状的出现频率增加了926%。尿失禁很少见。总体而言，治疗结束时症状负担较轻。结论放疗期间尿路症状常见，肠道症状较少。这些结果为患者和医生在决策过程中了解潜在的患者生活质量提供了参考，也为与新治疗和新技术进行有效性比较研究提供了一个基准。
OBJECTIVETo evaluate data collected from a phase II trial to describe the time course and trajectory of patient-reported acute urinary and bowel symptom development during radiation therapy (RT) for prostate cancer.PATIENTS AND METHODSIn all, 100 patients with intermediate- or high-risk prostate cancer received 72 Gy of RT to the prostate and seminal vesicles, with 6 months of concurrent androgen deprivation therapy; a rectal balloon was used for prostate immobilization.Patients completed the validated Prostate Cancer Symptom Indices questionnaire every 12 weeks, reporting urinary and bowel symptoms on a four- or five-point Likert scale.A score of =3 in a symptom is associated with clinically meaningful distress. Cumulative incidence of each symptom is reported. Bonferroni corrections of P values were used to adjust for multiple comparisons.RESULTSUrinary symptoms were frequent at baseline and worsened during treatment. By the end of RT, 2850% of patients developed clinically meaningful obstructive and irritative urinary symptoms.Acute bowel symptoms were less frequent. Each bowel symptom increased in frequency by 926% from baseline to end of RT.Urinary incontinence was rare.Overall, symptom burden at the end of treatment was modest.CONCLUSIONSUrinary symptoms were common during RT, and bowel symptoms were less frequent.These results inform patients and physicians during the decision-making process about potential patient quality of life experiences during RT, and also provide a benchmark for comparative effectiveness studies against newer treatments and technologies.