International journal of radiation oncology, biology, physics · 2025
Health-Related Quality of Life in Patients Treated for Nonmetastatic Muscle-Invasive Bladder Cancer: Radical Cystectomy Versus Bladder-Preserving Therapy.
СтатьяСравнительное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Brück Katharina, Atema Vera, Leliveld Annemarie M, Franckena Martine, Meijer Richard P, van der Heijden Michiel S, Donders A Rogier, Witjes J Alfred, Uyl-de Groot Carin A, van Hoogstraten Lisa M C, Kiemeney Lambertus A, Boormans Joost L, Aben Katja K H, Hulshof Maarten C C M, CRAC study group and the BlaZIB study group
Аннотация
PURPOSE: Patients with nonmetastatic muscle-invasive bladder cancer (MIBC) can be treated with either radical cystectomy (RC) or bladder-preserving therapy (BPT). Contemporary data on the impact of these treatments on health-related quality of life (HRQOL) are lacking.
METHODS AND MATERIALS: In our prospective national cohort study, patients were invited to complete HRQOL questionnaires at baseline, 12 and 24 months after diagnosis. We included patients with nonmetastatic MIBC, treated with either RC or BPT (chemoradiation or brachytherapy), who had completed ≥1 HRQOL questionnaire. HRQOL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC-QLQ-C30, version 3.0) and bladder cancer-specific symptoms were assessed using the EORTC-QLQ-Muscle-Invasive Bladder Cancer (QLQ-BLM30). We used linear mixed-effects models to analyze differences in HRQOL between the 2 treatment groups (range, 0-100).
RESULTS: A total of 292 patients completed the baseline questionnaire, 214 patients in the RC group and 78 in the BPT group. At 24 months, pain scores were lower and emotional function scores were higher in the RC group, with a between-group difference of -7.5 [95% confidence interval (CI), -12.7 to -2.2] and 6.2 (95% CI, 2.0-10.5), respectively. In contrast, cognitive function was higher in the BPT group, difference of -5.1 (95% CI, -9.2 to -1.0). On the BLM30, sexual function and enjoyment scores were higher in the BPT group. Male sexual symptoms scores and body image scores were lower in the BPT group, differences were 25.6 (95% CI, 11.2-39.9) and 9.3 (95% CI, 4.2-14.4), respectively. There were no significant differences in gastrointestinal symptoms. Difference in urinary symptoms could not be assessed because of 90% iliac conduits in the RC group.
CONCLUSION: At 2 years, BPT and RC resulted in equal HRQOL scores in most domains. Sexual symptoms and functioning, body image, and cognitive function were significantly better after BPT, RC resulted in better pain scores and emotional functioning. Insight into HRQOL outcomes can be used to guide shared decision making.
METHODS AND MATERIALS: In our prospective national cohort study, patients were invited to complete HRQOL questionnaires at baseline, 12 and 24 months after diagnosis. We included patients with nonmetastatic MIBC, treated with either RC or BPT (chemoradiation or brachytherapy), who had completed ≥1 HRQOL questionnaire. HRQOL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC-QLQ-C30, version 3.0) and bladder cancer-specific symptoms were assessed using the EORTC-QLQ-Muscle-Invasive Bladder Cancer (QLQ-BLM30). We used linear mixed-effects models to analyze differences in HRQOL between the 2 treatment groups (range, 0-100).
RESULTS: A total of 292 patients completed the baseline questionnaire, 214 patients in the RC group and 78 in the BPT group. At 24 months, pain scores were lower and emotional function scores were higher in the RC group, with a between-group difference of -7.5 [95% confidence interval (CI), -12.7 to -2.2] and 6.2 (95% CI, 2.0-10.5), respectively. In contrast, cognitive function was higher in the BPT group, difference of -5.1 (95% CI, -9.2 to -1.0). On the BLM30, sexual function and enjoyment scores were higher in the BPT group. Male sexual symptoms scores and body image scores were lower in the BPT group, differences were 25.6 (95% CI, 11.2-39.9) and 9.3 (95% CI, 4.2-14.4), respectively. There were no significant differences in gastrointestinal symptoms. Difference in urinary symptoms could not be assessed because of 90% iliac conduits in the RC group.
CONCLUSION: At 2 years, BPT and RC resulted in equal HRQOL scores in most domains. Sexual symptoms and functioning, body image, and cognitive function were significantly better after BPT, RC resulted in better pain scores and emotional functioning. Insight into HRQOL outcomes can be used to guide shared decision making.