Acute, Subchronic, and Chronic Complications of Radical Prostatectomy versus Radiotherapy with Hormone Therapy in Older Adults with High-Risk Prostate Adenocarcinoma

ASIA unversity > 醫學暨健康學院 > 食品營養與保健生技學系 > 期刊論文 > Item 310904400/115139

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题名:	Acute, Subchronic, and Chronic Complications of Radical Prostatectomy versus Radiotherapy with Hormone Therapy in Older Adults with High-Risk Prostate Adenocarcinoma
作者:	吳思遠;Wu, Szu-Yuan;Li, Chih Jung;Liao, Chih Jung;Chung-Chien;Huang, Chung-Chien
贡献者:	醫學暨健康學院食品營養與保健生技學系
关键词:	complications;high-risk localized prostate cancer;intensity-modulated radiotherapy;old age;radical prostatectomy.
日期:	2022-05-01
上传时间:	2023-03-29
出版者:	亞洲大學
摘要:	Purpose: To compare acute, subchronic, and chronic complications between older patients with high-risk localized prostate cancer (HR-LPC) receiving radical prostatectomy (RP) and high-dose intensity-modulated radiotherapy (IMRT) combined with long-term hormone therapy (HT). Patients and methods: We recruited older patients (?80 years) with HR-LPC from the Taiwan Cancer Registry database. After propensity score matching, logistic regression analysis was used to compare the acute, subchronic, and chronic complication rates between patients who underwent RP (the RP group) and high-dose IMRT combined with long-term HT (the IMRT+HT group). Results: Benign prostatic hyperplasia (BPH) symptoms and urinary incontinence (UI) were the most common complications over 5 years (BPH symptoms: RP, 17.69%; IMRT+HT, 29.58%; UI: RP, 10.47%; IMRT+HT, 5.50%). Compared with the RP group, the IMRT+HT group had higher odds of BPH symptoms and lower odds of UI and hernia after the 5-year follow-up period. The impotence rates were significantly higher in the IMRT+HT group than in the RP group at 3 months and 1 year after treatment and became nonsignificant after 2 years. At 5 years after treatment, the IMRT+HT group had lower risks of UI (adjusted odds ratio [aOR], 0.50; 95% confidence interval [CI], 0.28-0.88) and hernia (aOR, 0.21; 95% CI, 0.11-0.82) and a higher risk of BPH symptoms (aOR, 4.15; 95% CI, 2.82-7.37) than the RP group. Conclusion: IMRT+HT was associated with lower UI and hernia risks than RP. By contrast, RP was associated with fewer complications of BPH over the follow-up period and less impotence during the first year after treatment. Our findings provide important and valuable references for shared decision-making for optimal therapy selection among older men with HR-LPC.
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