Health-related quality of life in patients with locally advanced prostate cancer after 76 GY intensity-modulated radiotherapy vs. 70 GY conformal radiotherapy in a prospective and longitudinal study

Health-related quality of life in patients with locally advanced prostate cancer after 76 GY intensity-modulated radiotherapy vs. 70 GY conformal radiotherapy in a prospective and longitudinal study
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DOI:
10.1016/j.ijrobp.2007.04.013
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发表时间:
2007-11-01
影响因子:
7
通讯作者:
van Vulpen, Marco
van Vulpen, Marco
中科院分区:
医学1区
文献类型:
--
作者:
Lips, Irene;Dehnad, Human;van Vulpen, Marco

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目的:比较局部晚期前列腺癌患者接受70戈伊适形放疗后的生活质量(QoL)与接受76戈伊调强放疗(IMRT)后的生活质量(QoL)。方法和材料:78例局部晚期前列腺癌患者接受70戈伊适形放疗,92例患者接受76戈伊IMRT,并使用基准标记进行位置验证。在放疗前(基线)和治疗后1个月和6个月,采用兰德-36、欧洲癌症研究和治疗组织核心问卷(EORTC QLQ-C30(+3))和前列腺特异性EORTC QLQ-PR 25测量生活质量。生活质量的时间变化(基线与1个月和基线与6个月)>= 10点被认为是临床relevant.Results:治疗组之间的差异随着时间的推移生活质量的变化发生在几个生活质量域。与70-戈伊组相比,76-戈伊组的生活质量没有显著恶化。IMRT 76-戈伊组甚至在几个领域表现出从基线到1个月的QoL变化显著更好。适形70-戈伊组显示疼痛、角色功能和泌尿系统症状暂时恶化;对于IMRT 76-戈伊组,1个月后健康变化方面的生活质量更好,6个月后持续存在。对于两个治疗组,1个月后身体角色限制出现暂时恶化,6个月后情感角色限制出现改善。两组治疗后性活动减少,并保持下降6 months.Conclusions:强度调制放疗和准确的位置验证似乎提供了一种可能性,以增加前列腺癌的辐射剂量,而不恶化生活质量。(C)2007年爱思唯尔公司
Purpose: To compare quality of life (QoL) after 70 Gy conformal radiotherapy with QoL after 76 Gy intensity-modulated radiotherapy (IMRT) in patients with locally advanced prostate carcinoma.Methods and Materials: Seventy-eight patients with locally advanced prostate cancer were treated with 70 Gy three-field conformal radiotherapy, and 92 patients received 76 Gy IMRT with fiducial markers for position verification. Quality of life was measured by RAND-36, the European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30(+3)), and the prostate-specific EORTC QLQ-PR25, before radiotherapy (baseline) and 1 month and 6 months after treatment. Quality of life changes in time (baseline vs. 1 month and baseline vs. 6 months) of >= 10 points were considered clinically relevant.Results: Differences between the treatment groups for QoL changes over time occurred in several QoL domains. The 76-Gy group revealed no significant deterioration in QoL compared with the 70-Gy group. The IMRT 76-Gy group even demonstrated a significantly better change in QoL from baseline to 1 month in several domains. The conformal 70-Gy group revealed temporary deterioration in pain, role functioning, and urinary symptoms; for the IMRT 76-Gy group a better QoL in terms of change in health existed after 1 month, which persisted after 6 months. For both treatment groups temporary deterioration in physical role restriction occurred after I month, and an improvement in emotional role restriction occurred after 6 months. Sexual activity was reduced after treatment for both groups and remained decreased after 6 months.Conclusions: Intensity-modulated radiotherapy and accurate position verification seem to provide a possibility to increase the radiation dose for prostate cancer without deterioration in QoL. (C) 2007 Elsevier Inc.