Estimating Preferences for Treatments in Patients With Localized Prostate Cancer
Estimating Preferences for Treatments in Patients With Localized Prostate Cancer
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DOI：
10.1016/j.ijrobp.2014.09.044
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发表时间：
2015-02-01
影响因子：
7
通讯作者：
Ferrer, Montse
中科院分区：
文献类型：
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作者：
Avila, Monica;Becerra, Virginia;Ferrer, Montse
用途：关于患者对局部前列腺癌治疗偏好的研究评估了根治性前列腺切除术和外部放射治疗，但没有一项评估了近距离放射治疗。我们的研究的目的是评估的偏好和支付意愿的患者与局限性前列腺癌根治性前列腺切除术，外部放射治疗，或近距离放射治疗，其相关的泌尿，性，和肠道的副作用。方法和材料：这是一个观察性，前瞻性队列研究，随访至5年后治疗。从2003年到2005年，共有704例低或中等风险局限性前列腺癌患者被连续招募。偏好的估计进行了时间权衡，标准的赌博，并愿意支付的方法。副作用用扩展前列腺指数复合（EPIC），一种前列腺癌特异性问卷来测量。建立了Tobit模型来评估治疗和副作用对患者偏好的影响。倾向评分被应用于调整治疗选择bias.Results的偏好：580例患者报告，165例进行根治性直肠癌切除术，152例与外部放射治疗，263与近距离放射治疗。时间权衡和标准Gamble结果均表明，接受近距离放射治疗的患者的偏好比接受根治性切除术的患者高0.06效用（P=. 01）。同样，支付意愿的反应显示差异（原文如此）57/月（P=. 004)在这两种治疗之间。严重尿失禁对引发的偏好产生独立影响（P
Purpose: Studies of patients' preferences for localized prostate cancer treatments have assessed radical prostatectomy and external radiation therapy, but none of them has evaluated brachytherapy. The aim of our study was to assess the preferences and willingness to pay of patients with localized prostate cancer who had been treated with radical prostatectomy, external radiation therapy, or brachytherapy, and their related urinary, sexual, and bowel side effects.Methods and Materials: This was an observational, prospective cohort study with follow-up until 5 years after treatment. A total of 704 patients with low or intermediate risk localized prostate cancer were consecutively recruited from 2003 to 2005. The estimation of preferences was conducted using time trade-off, standard gamble, and willingness-to-pay methods. Side effects were measured with the Expanded Prostate Index Composite (EPIC), a prostate cancer-specific questionnaire. Tobit models were constructed to assess the impact of treatment and side effects on patients' preferences. Propensity score was applied to adjust for treatment selection bias.Results: Of the 580 patients reporting preferences, 165 were treated with radical prostatectomy, 152 with external radiation therapy, and 263 with brachytherapy. Both time trade-off and standard gamble results indicated that the preferences of patients treated with brachytherapy were 0.06 utilities higher than those treated with radical prostatectomy (P=. 01). Similarly, willingness-to-pay responses showed a difference of (sic)57/month (P=. 004) between these 2 treatments. Severe urinary incontinence presented an independent impact on the preferences elicited (P