Квалитет живота и резултати лечења болесника с неметастатским карциномом простате након примене тоталне андрогене блокаде самостално и с радиотерапијом

Abstract

Introduction Hormonal treatment of prostate cancer (CaP) in the form of total androgen blockade (TAB) with or without radiotherapy is applied in metastatic disease and in patients with nonmetastatic and localized disease as well.

Objective The aim of the study was to compare oncological results, residual and newly developed symptoms during treatment and the quality of life in patients with nonmetastatic CaP treated by using TAB and in a group treated both with TAB and radiotherapy (RT+TAB).

Methods Retrospective analysis of 126 patients with nonmetastatic CaP was performed. Follow-up was 36 months. Seventynine out of 126 patients were treated with TAB alone and 47 with TAB and radiotherapy (TAB+RT). Overall survival, metabolic syndrome appearance and the frequency of nonmalignant complications during treatment were analyzed. Urinary, digestive and sexual symptoms were analyzed, as well as the overall health condition of the patients.

Results Fatal outcome and/or disease progression occurred in 29 out of 126 patients (23%). High risk patients were significantly more frequent in the TAB+RT group (p=0.04). Mortality rate was not different in both groups indicating that better results of treatment were achieved in patients treated with TAB+RT. Metabolic syndrome appeared in 51.6% of TAB patients and in 51.1 of TAB+RT patients, and was significantly more frequent at the end of the follow-up than at the beginning of the treatment (p=0.003 in TAB and p=0.01 in TAB+RT group). Urinary symptoms were more frequent than digestive symptoms in both groups. The quality of life was slightly improved after the beginning of therapy to be followed by the tendency of gradual decrease.

Conclusion Both modalities of treatment were efficient. Therapy TAB+RT was more efficient in high risk patients. Metabolic syndrome was more frequent after a long-term administration of therapy than at the beginning. The quality of life was the most affected in sexually active patients.

Keywords: nonmetastatic prostate cancer; total androgen blockade; radiotherapy