文章：

既往经尿道前列腺切除术（TURP）或激光剜除术（ThuLEP）对接受根治性放疗的前列腺癌患者放疗相关毒性及生活质量的影响

Effect of Prior Transurethral Prostate Resection (TURP) or Laser Enucleation (ThuLEP) on Radiotherapy-Induced Toxicity and Quality of Life in Prostate Cancer Patients Undergoing Definitive Radiotherapy

原文发布日期：6 October 2024

DOI: 10.3390/cancers16193403

类型: Article

开放获取: 是

英文摘要：

In our study, the post-radiotherapy quality of life of prostate cancer patients who previously underwent transurethral resection of the prostate (TURP) is compared to those who had thulium laser enucleation of the prostate (ThuLEP) and those who had no prior surgery. It also aims to identify and assess risk factors affecting therapy tolerance in this patient group. We analyzed 132 patients with localized prostate cancer treated with definitive radiotherapy (RT), including 23 who had prior TURP and 19 who previously underwent ThuLEP. A total of 62% of patients underwent irradiation within 12 months after surgery. We included only patients treated with radiotherapy using the IMRT technique. Changes in patient-reported urinary toxicity were evaluated using the International Prostate Syndrome Score (IPSS) and the quality of life index of the World Health Organization (QoL/WHO-PSS) over a three-year post-radiotherapy period. Patients with prior TURP experienced significant deterioration in QoL and IPSS immediately after irradiation (p< 0.001), whereas those without previous surgery showed both less significant differences in IPSS and QoL scores. In conclusion, patients with previous TURP/ThuLEP differ from those without previous surgery in urinary quality of life and acute and chronic urinary symptom profiles after RT. The surgical technique (ThuLEP vs. TURP) and the time interval to irradiation are crucial factors affecting RT tolerance in acute and late settings. The previously operated patient group reported a significantly longer period of increased symptom burden.

摘要翻译： 

本研究旨在比较既往接受经尿道前列腺切除术（TURP）与铥激光前列腺剜除术（ThuLEP）以及未接受过手术的前列腺癌患者在接受放疗后的生活质量差异，并评估影响该患者群体治疗耐受性的风险因素。我们分析了132例接受根治性放疗的局限性前列腺癌患者，其中23例曾行TURP，19例曾行ThuLEP。62%的患者在术后12个月内接受了放疗，所有患者均采用调强放疗技术。通过国际前列腺症状评分（IPSS）和世界卫生组织生活质量指数（QoL/WHO-PSS），我们评估了患者放疗后三年内自我报告的泌尿系统毒性变化。结果显示，既往接受TURP的患者在放疗后即刻出现生活质量和IPSS评分的显著恶化（p<0.001），而未接受过手术的患者在IPSS和生活质量评分方面的差异较小。综上所述，既往接受TURP/ThuLEP的患者与未手术患者在放疗后的泌尿生活质量及急慢性泌尿症状表现上存在差异。手术方式（ThuLEP与TURP）以及手术至放疗的时间间隔是影响放疗急性期和远期耐受性的关键因素。既往接受手术的患者群体报告症状负担加重的时间显著延长。

原文链接：

Effect of Prior Transurethral Prostate Resection (TURP) or Laser Enucleation (ThuLEP) on Radiotherapy-Induced Toxicity and Quality of Life in Prostate Cancer Patients Undergoing Definitive Radiotherapy