前列腺癌患者治疗中度或超低分化后肠道和泌尿功能的治疗后变化:一个前性队列研究
W D Heemsbergen1, F Sinzabakira1, K C de Vries1
1Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
Clinical and translational radiation oncology
|April 18, 2025
概括
前列腺癌 (PCa) 中度 (MHF) 或超低分离 (UHF) 放射治疗后与健康相关的生活质量 (HRQoL) 结果显示与试验数据相似的变化. 肠道和泌尿功能下降影响了整体健康,尿道问题与急性毒性有关.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在前列腺癌 (PCa) 临床试验中,低分离 (HF) 已被确定为安全.
- 在PCa中适度 (MHF) 和超低分离 (UHF) 放射治疗后,关于与健康相关的生活质量 (HRQoL) 的现实数据有限.
- 了解治疗后的HRQoL对于PCa放射治疗中以患者为中心的护理至关重要.
研究的目的:
- 在现实PCa患者群体中评估MHF或UHF放射治疗后HRQoL结果的治疗后变化.
- 为了比较MHF和UHF治疗组之间的HRQoL变化.
- 确定影响PCa放射治疗后HRQoL恶化的因素.
主要方法:
- 对接受MHF (n=140) 或UHF (n=138) 的T1-4N0M0 PCa患者进行前性队列研究.
- 患者在基线和治疗后6个月完成了EPIC尿/肠领域和EQ-5D-5L.
- 最小临床重要差异 (MCID) 定义为8%;用于预后因素评估的回归模型.
主要成果:
- 20%和17%的患者患有MCID,分别出现了肠道和尿路功能的恶化.
- 肠道和泌尿功能恶化与一般健康状况下降,正常活动以及疼痛/不适相关.
- 尿路状况恶化的预测因素包括抗雄激素剥夺疗法,75岁以上,MHF和2级以上的急性尿路毒性.
结论:
- 在接受MHF和UHF治疗的真实PCa群体中,治疗后HRQoL的变化与之前的试验结果相比.
- 肠道和尿路功能的恶化显著影响了整体健康状况.
- 急性尿路毒性成为PCa放射治疗后尿路功能丧失的后果因素.
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