前列腺癌患者单纯雄激素去除治疗后健康相关生活质量的评估

The evaluation of health-related quality of life for prostate cancer patients receiving androgen deprivation therapy

目的评估前列腺癌患者单纯雄激素去除治疗（androgen deprivation therapy，ADT）后的健康相关生活质量（health－related quality of life，HRQOL）。方法选取2014年6月至2015年6月接受单纯ADT且符合本研究入组标准的前列腺癌患者共200例，平均年龄73.9岁。诊断前列腺癌时平均PSA为21.57 ng/ml。158例（79%）为局限性前列腺癌，因年龄、身体状况、基础疾病、患者个人意愿等接受ADT，42例（21%）为局部晚期或转移性前列腺癌，符合ADT指征。应用简明健康生活量表（the MOS item short from health survey，SF－36）、癌症患者生活质量测定量表的通用模块（functional assessment of cancer therapy－general module，FACT－G）、前列腺癌治疗功能评价量表（functional assessment of cancer therapy －prostate instrument，FACT－P）、抑郁自评量表（self－rating depression scale，SDS）和焦虑自评量表（self－rating anxiety scale，SAS）等调查患者的HRQOL。结果本组200例患者的SF－36生理健康总得分、心理健康总得分分别为（67.41±16.39）分、（64.81±17.51）分，表明患者总体生活质量尚可，除一般健康维度得分为（40.03±21.89）分，其余7个维度平均得分均〉60分。FACT－P中情感维度得分、前列腺癌模块得分以及FACT－P总分均较低，分别为（8.15±3.72）分、（12.30±4.04）分、（77.41±9.95）分，均不足最高得分的50%，而生理状况得分相对较好，为（20.41±4.29）分；且121例（61%）患者在FACT－P的＂我能够达到并保持勃起＂条目中选择了＂一点也不＂选项。SDS平均得分为（46.76±8.29）分，SAS平均得分为（43.25±9.69）分，分别有46例（23.0%）和43例（21.5）患者出现不同程度的抑郁和焦虑。结论前列腺癌患者接受单纯ADT后总体生活状况尚可，但出现了不同程度的抑郁、焦虑、勃起功能障碍等不良反应。

Objective To evaluate the health-related quality of life （HRQOL） for prostate cancer patients receiving androgen deprivation therapy （ADT）. Methods We studied 200 patients with prostate cancer who were treated with primary ADT in Peking University People＇s Hospital from June 2014 to June 2015. The patients＇average age was 73.9 years. The mean PSA level was 21.57 ng/ml when they were diagnosed with prostate cancer. Of these 200 patients,79% （158/200） were localized and seeleeted ADT therapy due to age, body condition, basic diseases or individual will. 21% （42/200） were locally advanced or metastasic, which accord with the indication of ADT therapy. The scales, including the MOS item short from health survey （ SF-36）, Functional Assessment of Cancer Therapy -General module （ FACT-G）, Functional Assessment of Cancer Therapy -Prostate instrument （ FACT-P）, Self-Rating Depression Scale （SDS） and Self-Rating Anxiety Scale （SAS） were used to evaluate their HRQOL. Results According to results of SF- 36, the physical health component score and mental health component score was 67.41 ± 16. 39 and 64. 81±17.51, respectively. They indicated that the overall quality of life of these patients was at an acceptable level. And the average score of all domains exceeded 60 except general health domain, which the score was only 40. 03±21.89. When it comes to FACT-P, the sum score, emotional well-being score and prostate cancer component score were 8.15 ± 3.72,12. 30± 4. 04 and 77. 41 ±9. 95, respectively, which were less than half of their respective top score. However the physical well-being score was 20.41 ± 4. 29 ,which was a relatively satisfactory value. In addition, 61% （121/200） patient selected ＂not at all＂ in item ＂1 am able to have and keep an erection＂. The score of SDS and SAS was 46. 76 ± 8.29 and 43.25 ±9.69, respectively. And there were 23.0% （46/200） and 21.5% （ 43/200 ） patiens exhibited depression and anxiety, respectively. Conclusion In the present study, the prostate cancer patients receiving ADT showed acceptable HRQOL, but some patients sufferd from depression, anxiety and erectile dysfunction.