Purpose:This is a secondary analysis examining a six-month home-based Prostate Cancer-Patient Empowerment Program (PC-PEP) on patient-reported urinary, bowel, sexual, and hormonal function in men with curative prostate cancer (PC) against standard of care.Methods:In a crossover clinical trial, 128 men scheduled for PC surgery (n = 62) or radiotherapy with/without hormones (n = 66) were randomized to PC-PEP (n = 66) or waitlist-control and received the standard of care for 6 months, and then PC-PEP to the end of the year. PC-PEP included daily emails with video instructions, aerobic and strength training, dietary guidance, stress management, and social support, with an initial PFMT nurse consultation. Over 6 months, participants in the PC-PEP received optional text alerts (up to three times daily) reminding them to follow the PFMT video program, encompassing relaxation, quick-twitch, and endurance exercises; compliance was assessed weekly. Participants completed baseline, 6, and 12-month International Prostate Symptom Score (IPSS) and Expanded Prostate Cancer Index Composite (EPIC) questionnaires.Results:At 6 months, men in the PC-PEP reported improved urinary bother (IPSS,p= 0.004), continence (EPIC,p< 0.001), and irritation/obstruction function (p= 0.008) compared to controls, with sustained urinary continence benefits at 12 months (p= 0.002). Surgery patients in the waitlist-control group had 3.5 (95% CI: 1.2, 10,p= 0.024) times and 2.3 (95% CI: 0.82, 6.7,p= 0.11) times higher odds of moderate to severe urinary problems compared to PC-PEP at 6 and 12 months, respectively.Conclusions:PC-PEP significantly improves lower urinary tract symptoms, affirming its suitability for clinical integration alongside established mental health benefits in men with curative prostate cancer.
目的：本研究为一项二次分析，旨在评估为期六个月的家庭式前列腺癌患者赋能计划（PC-PEP）相较于标准护理，对接受根治性治疗的前列腺癌患者自我报告的泌尿、肠道、性功能及激素水平的影响。 方法：在一项交叉临床试验中，128名计划接受前列腺癌手术（n=62）或放疗（伴/不伴激素治疗，n=66）的男性患者被随机分配至PC-PEP组（n=66）或等待列表对照组，两组均接受6个月标准护理，随后PC-PEP组继续接受干预至年底。PC-PEP干预包括每日发送含视频指导的电子邮件、有氧与力量训练、饮食指导、压力管理及社会支持，并包含首次盆底肌训练护士咨询。在6个月内，PC-PEP组参与者每日可接收至多三次可选短信提醒，以督促其遵循包含放松、快速收缩及耐力训练的盆底肌训练视频计划；每周评估依从性。参与者在基线、6个月及12个月时完成国际前列腺症状评分量表（IPSS）和扩展版前列腺癌综合指数问卷（EPIC）。 结果：6个月时，与对照组相比，PC-PEP组患者在泌尿困扰（IPSS，p=0.004）、尿控能力（EPIC，p<0.001）及刺激/梗阻症状（p=0.008）方面均有改善，且尿控获益持续至12个月（p=0.002）。等待列表对照组中的手术患者在6个月和12个月时出现中重度泌尿问题的比值比分别是PC-PEP组的3.5倍（95% CI：1.2-10，p=0.024）和2.3倍（95% CI：0.82-6.7，p=0.11）。 结论：PC-PEP能显著改善下尿路症状，结合既往研究证实的心理健康获益，表明该计划适合临床推广应用于接受根治性治疗的前列腺癌患者。
Six-Month Prostate Cancer Empowerment Program (PC-PEP) Improves Urinary Function: A Randomized Trial
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