间歇性雄激素阻断治疗对晚期前列腺癌患者生活质量的影响

目的: 调查间歇性雄激素阻断治疗(Intermittent Androgen Blockade,IAB)对晚期前列腺癌患者生活质量的影响。 方法: 采用EORTCQLQ-C30总量表和QLQ-PR25子量表对51例接受IAB治疗的晚期前列腺癌患者,分别在治疗前、治疗后6个月和治疗后12个月进行3次生活质量调查。 结果: 尽管IAB使家庭经济负担加重(P<0.05),但在间歇期负担减轻(P<0.05)。IAB治疗6个月后患者总体健康状况明显好转(P<0.01),尤其在治疗间歇期更加明显(P<0.05);全身或局部疼痛缓解(P<0.01);排尿症状改善(P<0.01);虽然治疗6个月时患者躯体(P<0.05)、角色(P<0.05)、情绪(P<0.01)、社会(P<0.01)等功能均有不同程度下降,且疲倦加剧(P<0.01),但在12个月进入间歇期后这些功能逐渐恢复。治疗相关症状如潮红与乳房胀痛等在6个月时显著出现(P<0.01),但12个月时减轻(P<0.01)。治疗期性趣明显下降(P<0.01)、性生活丧失,但在间歇期有不同程度的恢复(P<0.01)。 结论: 虽然IAB对晚期前列腺癌患者的机体与心理有不同程度的影响,但其是可恢复的。

The Impact of Intermittent Androgen Blockade on the Quality of Life for Patients with Advanced Prostate Cancer

Objective: To investigate the quality of life of patients with advanced prostate cancer after treatmentwith intermittent androgen blockade(IAB). Methods: A total of 51 patients with advanced prostate cancer treated with IABunderwent the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30) andthe QLQ-prostate specific 25-item module (PR25). The assessment was made 3 times: once before treatment, once 6months after treatment and once 12 months after treatment. Results: In spite of the increased financial burden, IAB bene-fited patients. At 6 and 12 months after treatment, improvement was observed in pain relief, urinary symptoms and globalhealth (P<0.01). Six months after treatment, patients treated with IAB presented with decreased physical, role, emotionaland social functions compared to those same patients before treatment(P<0.01). At that time patients also had symptoms re-lated to the treatment itself including flushed skin, breast pain and decreased libido. The above functions were improvedand the treatment-related symptoms were relieved by the 12th month after treatment. Conclusion: IAB can effectively im-prove the quality of life for patients with advanced prostate cancer. It temporarily impairs physical and psychological func-tions, but these functions can be fully recovered within 12 months of treatment.