在晚期前列腺癌患者中,局部治疗和与治疗相关的不良影响
Saira Khan1,2, Su-Hsin Chang2, Mei Wang1,2
1Research Service, St Louis Veterans Affairs Medical Center, St Louis, Missouri.
JAMA network open
|December 18, 2023
概括
晚期前列腺癌的局部治疗,如激进前列腺切除术或放射治疗,与持久的不良影响有关. 这些副作用会影响胃肠道,性和尿路功能,治疗后持续数年.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 临床研究 临床研究
背景情况:
- 晚期前列腺癌治疗决策涉及平衡生存效益与不良影响.
- 对于晚期前列腺癌局部治疗的长期不良影响的证据有限.
研究的目的:
- 评估局部治疗 (急性前列腺切除术或辐射) 与晚期前列腺癌男性治疗相关不良影响之间的关联.
主要方法:
- 一项对5502名患有晚期前列腺癌 (T4,N1,M1) 的男性进行队列研究,在1999-2013年间在退伍军人卫生管理中心接受治疗.
- 在治疗后3次间隔 (≤1年,>1-≤2年,>2-≤5年) 评估了不良反应 (宪法,肠道,疼痛,性,尿道).
主要成果:
- 当地治疗与第一年内胃肠道,疼痛,性和尿路不良反应的几率更高有关.
- 这些关联持续超过2年,局部治疗与持续的胃肠道,性和尿道问题相关,治疗后长达5年.
- 在局部 (75.2%) 和非局部 (67.1%) 治疗组中观察到持续不良状况 (>2-5年) 的高患病率.
结论:
- 晚期前列腺癌的局部治疗与多个领域的持续不良影响有关.
- 患者和临床医生在做出晚期前列腺癌治疗决策时,应仔细考虑这些长期不良影响.
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