Factors associated with current and severe physical side-effects after prostate cancer treatment: What men report
Factors associated with current and severe physical side-effects after prostate cancer treatment: What men report
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DOI：
10.1111/ecc.12589
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发表时间：
2018-01-01
影响因子：
2.1
通讯作者：
Gavin, A.
中科院分区：
文献类型：
--
作者：
Steentjes, L.;Siesling, S.;Gavin, A.
我们确定了患者和疾病特征与（1）任何严重程度的当前身体副作用;（2）爱尔兰3，348例（54%）前列腺癌（PCa）幸存者在2- 18年前诊断的“曾经”经历的“严重”身体副作用。邮寄问卷收集诊断时的症状、活检后并发症、合并症、主要治疗和治疗后的身体副作用（尿失禁、勃起功能障碍、性欲丧失、肠道问题、乳房变化、潮热和疲劳，在问卷完成时“曾经”和“当前”）。男性在诊断时按“早期”（局部）和“晚期”（局部晚期/晚期）疾病分组。多变量logistic回归分析确定了与治疗后副作用相关的患者和疾病相关因素。活检后并发症与“当前”性欲丧失和阳痿的风险较高相关。根治性尿道切除术与早期和晚期疾病中“当前”和“严重”尿失禁、性欲丧失和阳痿的风险较高相关。在疾病早期，近距离放射治疗与“当前”疲劳和“严重”阳痿的风险较低有关。合并症与四种副作用（尿失禁、性欲丧失、肠道问题、疲劳）的“当前”经历风险较高相关。积极监测/观察等待的男性报告性功能障碍的风险较低。这些研究结果可以为开发关于副作用的定制信息提供信息，而这些信息反过来又可以为治疗决策和治疗后监测提供信息。
We identified patient and disease characteristics associated with (1) current physical side-effects of any severity; and (2) "severe" physical side-effects "ever" experienced by 3,348 (54%) prostate cancer (PCa) survivors in Ireland diagnosed 2-18years previously. Postal questionnaires collected symptoms at diagnosis, post-biopsy complications, comorbidities, primary treatments and physical side-effects post-treatment (urinary incontinence, erectile dysfunction, libido loss, bowel problems, breast changes, hot flushes, and fatigue, "ever" and "current" at time of questionnaire completion). Men were grouped by "early" (localised) and "late" (locally advanced/advanced) disease at diagnosis. Multivariable logistic regression analysis identified patient and disease-related factors associated with post-treatment side-effects. Complications post-biopsy were associated with higher risk of "current" libido loss and impotence. Radical prostatectomy was associated with higher risk of "current" and "severe" incontinence, libido loss and impotence in both early and late disease. In early disease, brachytherapy was associated with lower risk of "current" fatigue and "severe" impotence. Comorbidities were associated with higher risk of "current" experience of four side-effects (incontinence, libido loss, bowel problems, fatigue). Men on active surveillance/watchful-waiting reported lower risk of sexual dysfunction. These findings could inform development of tailored information on side-effects, which, in turn, could inform treatment decision-making and post-treatment monitoring.