通过患者报告的结果测量局部性前列腺癌新治疗方式的比较有效性
Víctor Zamora1,2,3, Olatz Garin1,2,4, José Francisco Suárez5
1Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute) Barcelona, Spain.
Clinical and translational radiation oncology
|November 29, 2023
概括
针对局部性前列腺癌的积极监测具有较少的副作用,但可能会影响身体健康. 机器人辅助手术和放射治疗可以分别导致尿道和肠道问题.
科学领域:
- 在瘤学瘤学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 健康 结果 研究 研究 结果
背景情况:
- 局部性前列腺癌治疗有效性的研究是有限的.
- 患者报告的结果指标 (PROM) 对于评估治疗影响至关重要.
研究的目的:
- 为了比较主动监测,机器人辅助激进前列腺切除术 (RARP),强度调节放射治疗 (IMRT) 和局部前列腺癌实时支臂治疗的有效性.
- 通过PROMs评估治疗对副作用 (失禁,尿道症状,性功能障碍,肠道症状) 和身体/精神健康的影响.
主要方法:
- 在西班牙18家医院对572名50至75岁的前列腺癌患者进行前性队列研究.
- 随访时间长达24个月,EPIC-26和SF-36v2 PROMs通过电话采访进行.
- 用于分析数据和考虑治疗选择偏差的概括估计方程模型和倾向得分权重.
主要成果:
- 积极监测显示副作用最少,但显著的性功能障碍和身体健康下降,以及心理健康的改善.
- 与主动监测相比,机器人辅助激进前列腺切除术 (RARP) 导致尿失禁增加.
- 强度调节放射疗法 (IMRT) 和实时支臂疗法导致肠道症状恶化.
结论:
- 对于局部性前列腺癌,大多数治疗副作用都是短期的.
- 在RARP后的尿失禁和IMRT或支臂治疗后的肠道问题可能会持续.
- 积极监测,IMRT和实时支臂疗法显示了中等程度的心理健康改善.
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