局限性前列腺癌行根治性手术与根治性放疗后患者疗效和并发症的研究

Study on the etficacy and complications of patients undergoing radical surgery and radical radiotherapy for localized prostate cancer

目的:比较局限性前列腺癌行根治性手术(RP)与根治性放疗(RRT)两种治疗方法的疗效及并发症。方法:回顾性分析2015年1月至2019年12月在东部战区总医院确诊为局限性前列腺癌,接受RP治疗和RRT治疗的患者的临床资料,观察并记录患者术前和术后PSA水平、无生化复发生存率和无临床复发生存率,血尿、尿失禁、勃起功能障碍、尿道狭窄、腹泻、直肠出血、放射性膀胱炎的发生情况。结果:共有150例局限性前列腺癌患者纳入本次研究,其中行RP治疗的患者有105例,行RRT治疗的患者有45例。两组患者在血尿、尿失禁、勃起功能障碍和尿道狭窄等并发症的发生率之间差异无统计学意义(P>0.05)。RRT组患者在腹泻(20.00%vs 2.86%)、直肠出血(15.56%vs 1.90%)和放射性膀胱炎(13.33%vs 0%)的发生率高于RP组,差异具有统计学意义(P<0.05)。RP组患者5年bRFS高于RRT组(95.1%vs 90.7%),差异无统计学意义(P=0.832);RP组患者的5年cRFS高于RRT组(91.2%vs 89.6%),差异无统计学意义(P=0.971)。结论:RP组在腹泻、直肠出血和放射性膀胱炎的发生率低于RRT组,两组患者无复发生存无显著差异。

Objective:To compare the efficacy and complications of radical surgery(RP)and radical radiotherapy(RRT).Methods:The clinical data of patients diagnosed with localized prostate cancer in General Hospital of Eastern Theater Command with RP and RRT from January 2015 to December 2019,Observed and recorded patient preoperative and postoperative PSA levels,biochemical Relapse-free Survival and clinical Relapse-free Survival,and the occurrence of hematuria,urinary incontinence,erectile dysfunction,ankylurethria,diarrhea,hemoproctia and radiocystitis.Results:A total of 150 patients with localized prostate cancer were included in this study,including 105 patients with RP and 45 patients undergoing RRT.There was no significant difference between the complication rates of hematuria,urinary incontinence,erectile dysfunction and ankylurethria(P>0.05).Patients in the RRT group had higher rates of diarrhea(20.00%vs 2.86%),hemoproctia(15.56%vs 1.90%)and radiocystitis(13.33%vs 0%)than those in the RP group,with significant differences(P<0.05).The 5-year bRFS was lower than that in the RP group(95.1%vs 90.7%),with no statistical significance(P=0.832);the 5-year cRFS in the RP group was lower than that in the RRT group(91.2%vs 89.6%),with no significant difference(P=0.971).Conclusion:The incidence of diarrhea,hemoproctia and radiocystitis was lower in the RP group than in the RRT group,and the recurrence-free survival was not significantly different between the two groups.