27 juli 2005: Bron: BJU Int. 2005 Jul;96(1):43-7 en Medscape

Hoge dosis brachy therapy, is lokale bestraling van prostaatkanker met uitwendige bestraling, geeft aanzienlijk minder klachten dan volledige operatieve verwijdering van de prostaat bij de diagnose primaire prostaatkanker zonder uitzaaiïngen. We tekenen er wel bij aan dat deze studie redelijk kleinschalig is, resp. 89 en 93 patiënten namen deel en de follow-up - vijf jaar - is uitgevoerd door een per e-mail uitgevoerde corespondentie over kwaliteit van leven. Er hebben toch nogal wat mensen niet gereageerd op de e-mailcorrespondentie (32 patiënten reageerden niet = toch ca. 15%) en dit kan de resultaten beïnvloed hebben. Maar dan nog is het verschil wel opmerkelijk. Vooral de functie van urineren en sexuele functies werden in de brachy groep als beter ervaren.

Radical prostatectomy versus high-dose rate brachytherapy for prostate cancer: effects on health-related quality of life.

Jo Y, Junichi H, Tomohiro F, Yoshinari I, Masato F.
Department of Urology, Kawasaki Medical School, Kurashiki, Japan. jo@med.kawasaki-m.ac.jp

OBJECTIVE: To examine the effects of different treatments on the health-related quality of life (HRQoL) of men with localized prostate cancer.

PATIENTS AND METHODS: Between October 1997 and August 2002, 182 men diagnosed with prostate cancer (T1c to T3bN0M0) had radical prostatectomy (RP, 89) or (192)iridium high-dose rate brachytherapy (HDR-BT, 93) with external beam radiotherapy, and were followed for > or = 6 months. A postal survey was sent in which HRQoL was assessed using the 36-item Short-Form Health Survey (SF-36) QoL questionnaire, and disease-specific QoL using the University of California Los Angeles Prostate Cancer Index (UCLA-PCI).

RESULTS: Questionnaire responses were obtained from 151 of 182 patients; there was no significant difference in SF-36 scale scores between men treated with RP or HDR-BT. In the UCLA-PCI, the HDR-BT group had better urinary function (P < 0.001) and sexual function scores (P= 0.043). Men treated with RP had better bowel bother scores (P = 0.027). In patients with > or = 2 years of follow-up, urinary function (P < 0.001) and sexual bother (P = 0.029) were better for men treated with HDR-BT than for men treated with RP. Men treated with HDR-BT had significantly better urinary function (P = 0.009) and sexual bother (P = 0.013) even than 30 men treated with unilateral nerve-sparing RP.

CONCLUSIONS: In terms of HRQoL, RP and HDR-BT did not differ, but HDR-BT resulted in better urinary and sexual function than RP. When planning treatment, QoL concerns, including mental health issues associated with prostate cancer, need to be addressed with the patients, as do the potential side-effects.

PMID: 15963118 [PubMed - in process]

Hier een artikel over deze studie uit Medscape

In Prostate Cancer Treatment, Quality of Life Better With Radiation NEW YORK (Reuters Health) Jul 19 - In men with localized prostate cancer, high-dose rate brachytherapy has a better outcome for sexual life than does unilateral nerve-sparing radical prostatectomy, according to survey findings. "The prognosis associated with localized prostate cancer is excellent, with a 5-year relative survival rate approaching 100%," Dr. Yoshimasa Jo and colleagues from Kawasaki Medical School in Kurashiki note in the July issue of BJU International. Therefore, they charge, quality of life issues are "key to deciding among treatment options which can impinge on everyday activities to differing extents." To assess the differing effects that brachytherapy and radical prostatectomy may have on overall and disease-specific health-related quality of life, Dr. Jo's team surveyed 89 men who underwent radical prostatectomy and 93 who had iridium high-dose rate brachytherapy with external beam radiotherapy. The men were followed for between 6 and 64 months. Seventy men who had surgery and 81 who had brachytherapy responded to the mailed survey. According to the investigators, quality of life scores on the Short-Form 36, a general health-related quality of life questionnaire, were similar between men who had surgery and those who had brachytherapy. However, responses to a disease-specific quality of life questionnaire showed that men who opted for brachytherapy had significantly better urinary function (p < 0.001) and sexual function (p = 0.043) than men who had surgery. Even when compared with 30 men treated with unilateral nerve-sparing radical prostatectomy, men who had brachytherapy had a significantly better outcome in terms of their sexual health, the team reports. Men who had surgery had better "bowel bother" scores (p = 0.027) than men treated with brachytherapy. "When planning treatment," Dr. Jo's team concludes, "quality of life concerns, including mental health issues associated with prostate cancer, need to be addressed with the patients, as do the potential side effects." BJU Inter 2005;96:43-47.

Plaats een reactie ...

Reageer op "Bestraling via brachy therapie tegenover volledige operatie bij prostaatkanker zonder uitzaaiïngen geeft aanzienlijk minder klachten over incontinentie en sexueel functioneren en dus betere kwaliteit van leven."


Gerelateerde artikelen