| 同期调强放疗联合内分泌治疗对局部晚期前列腺癌患者生存质量的影响 |
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| 引用本文： | 骆华春,程丽萍,程惠华,傅志超,廖绍光,李东石,郑文发. 同期调强放疗联合内分泌治疗对局部晚期前列腺癌患者生存质量的影响[J]. 肿瘤研究与临床, 2014, 0(4): 260-265 |
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| 作者姓名： | 骆华春 程丽萍 程惠华 傅志超 廖绍光 李东石 郑文发 |
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| 作者单位： | 南京军区福州总医院放疗科, 350025 |
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| 摘 要： | 目的 评价局部晚期前列腺癌患者同期调强放疗联合内分泌治疗后生存质量的变化,为晚期前列腺癌患者的治疗模式提供理论依据.方法 对符合纳入标准的中晚期前列腺癌患者采用同步三维适形调强放疗（2.2 Gy/次,总剂量68.2 Gy）联合内分泌（口服比卡鲁胺50 mg,每日1次,皮下注射戈舍瑞林3.6 mg,每28d1次,持续2.5年）治疗.采用前列腺癌症状评分表（EPIC）进行长期问卷调查,随访时间分别为治疗前、治疗后3个月、12个月、36个月、48个月、60个月,问卷内容包括泌尿功能领域、肠道功能领域、性功能领域和激素功能领域.结果 2002年至2007年,共87例中晚期前列腺癌患者被纳入研究.中位随访时间为76.8个月,各随访时间点分别有87、87、86、81、75、65、56、47.与基线评价相比,4个功能领域的总积分均出现不同程度的下降,泌尿系统领域积分、肠道领域积分、激素领域积分下降明显,差异有统计学意义（P＜0.05）;治疗后3个月的肠道功能领域积分最低,总积分、功能、症状得分分别为75.7、78.4、72.8分;性功能领域积分差异无统计学意义（P＞0.05）;在尿失禁和排尿困难方面,积分变化值分别为-13.0±8.3和-6.12±3.9,差异有统计学意义（P＜0.05）.结论 中晚期前列腺癌患者采用同期调强放疗联合内分泌治疗生存质量出现不同程度的下降,主要在泌尿系统领域、肠道领域和激素领域,但在随访的5年内尚可耐受.
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| 关 键 词： | 前列腺肿瘤 生活质量 放射疗法 预后 |
Impact of intensity modulated radiotherapy combined with androgen deprivation on the quality of life for local advanced prostate cancer patients |
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| Luo Huachun,Cheng Liping,Cheng Huihua,Fu Zhichao,Liao Shaoguang,Li Dongshi,Zheng Wenfa. Impact of intensity modulated radiotherapy combined with androgen deprivation on the quality of life for local advanced prostate cancer patients[J]. Cancer Research and Clinic, 2014, 0(4): 260-265 |
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| Authors: | Luo Huachun Cheng Liping Cheng Huihua Fu Zhichao Liao Shaoguang Li Dongshi Zheng Wenfa |
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| Affiliation: | ( Department of Radiation Oncology, Fuzhou General Hospital of Nanjing Command, Fuzhou 350025, China) |
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| Abstract: | Objective To evaluate long-term changes in health-related quality of life （QOL） of patients with local advanced prostate cancer after intensity modulated radiotherapy （IMRT） combined with androgen deprivation therapy.Methods The patients who met the criteria for this study were enrolled and were treated with IMRT combined with androgen deprivation.The total dose of radiation was 68.2Gy（2.2Gy per fraction）.QOL was evaluated before and 3,12,36,48 and 60 months after treatment using the Expanded Prostate Cancer Index Composite（EPIC）,a validated tool that assesses four primary domains （urinary,bowel,sexual and hormonal）.Results From 2002 to 2007,87 patients were enrolled.At each follow-up time point,the number of cases was 87,87,86,81,75,65,56 and 47,respectively.The median follow-up time was 76.8 months.Compared with baseline assessment,all of four domain scores were declined in follow-up assessments.The mean score of urinary,bowel and hormonal domains were significantly reduced.At 3 months after treatment,the scores of bowel domain were lowest,in which the total,function and symptom scores were 75.7,78.4 and 72.8,respectively.However,there was no statistically significant difference in the mean sexual domain score.The mean change scores in urinary incontinence and obstructive were-13.0±8.3 and-6.12±3.9,respectively.Conclusions IMRT combined with androgen deprivation therapy was well tolerated in patients with local advanced prostate cancer.QOL was decreased in urinary,bowel and hormonal toxicity,most of which could be tolerated in five years. |
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| Keywords: | Prostatic neoplasms Quality of life Radiotherapy Prognosis |
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