Quality of life compared during pharmacological treatments and clinical monitoring for non-localized prostate cancer: a randomized controlled trial

被引:95
作者
Green, HJ
Pakenham, KI
Headley, BC
Yaxley, J
Nicol, DL
Mactaggart, PN
Swanson, CE
Watson, RB
Gardiner, RA
机构
[1] Univ Queensland, Sch Psychol, Brisbane, Qld, Australia
[2] Univ Queensland, Dept Surg, Brisbane, Qld, Australia
[3] Royal Brisbane Hosp, Brisbane, Qld 4029, Australia
[4] Princess Alexandra Hosp, Brisbane, Qld 4102, Australia
[5] Queen Elizabeth II Hosp, Brisbane, Qld, Australia
[6] Mater Hosp, Brisbane, Qld, Australia
关键词
prostate cancer; LHRH analogues; cyproterone acetate; quality of life; cognition; memory;
D O I
10.1111/j.1464-410X.2004.04763.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
To investigate the effects of different management strategies for non-localized prostate cancer on men's quality of life and cognitive functioning. Men with prostate cancer were randomly assigned to one of four treatment arms: leuprorelin, goserelin, cyproterone acetate (CPA), or close clinical monitoring. In a repeated-measures design, men were assessed before treatment (baseline) and after 6 and 12 months of treatment. A community comparison group of men of the same age with no prostate cancer participated for the same length of time. The men were recruited from public and private urology departments from university teaching hospitals. All those with prostate cancer who were eligible for hormonal therapy had no symptoms requiring immediate therapy. In all, 82 patients were randomized and 62 completed the 1-year study, and of the 20 community participants, 15 completed the study. The main outcome measures were obtained from questionnaires on emotional distress, existential satisfaction, physical function and symptoms, social and role function, subjective cognitive function, and sexual function, combined with standard neuropsychological tests of memory, attention, and executive functions. Sexual dysfunction increased for patients on androgen-suppressing therapies, and emotional distress increased in those assigned to CPA or close clinical monitoring. Compared with before treatment there was evidence of an adverse effect of leuprorelin, goserelin, and CPA on cognitive function. In deciding the timing of androgen suppression therapy for prostate cancer, consideration should be given to potential adverse effects on quality of life and cognitive function.
引用
收藏
页码:975 / 979
页数:5
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