Sex or Survival Short-Term Versus Long-Term Androgen Deprivation in Patients With Locally Advanced Prostate Cancer Treated With Radiotherapy

作者：Wilke Derek R^*; Krahn Murray; Tomlinson George; Bezjak Andrea; Rutledge Robert; Warde Padraig

来源：Cancer, 2010, 116(8): 1909-1917.

DOI：10.1002/cncr.24905

• prostate cancer
• patient preferences
• probability trade-off
• androgen deprivation

BACKGROUND: Combined long-term androgen deprivation (LTAD) and radiation conveys a prostate cancer-specific survival advantage over combined short-term androgen deprivation (STAD) and radiation. The seminal question is whether or not the gains are worth the adverse effects of LTAD with respect to patient preferences. METHODS: Preferences for LTAD compared with STAD were elicited by direct patient interview using the probability trade-off method. Time trade-off utilities" (TTOu) for erectile dysfunction and osteoporosis were elicited using the time trade-off method. Participants current prostate cancer specific health state was assessed using the Patient Oriented Prostate Utility Scale Psychometric Participants' current sexual function was assessed using the International Index of Erectile IIEF). RESULTS: All participants were willing to trade survival rather than undergo LTAD compared with STAD. The mean minimally required increment in prostate cancer specific survival (MRIS) was 8.2%. The mean TTOu for impotence was 0.78, and the mean TTOu for osteoporosis was 0.71. The MRIS was correlated with the Sexual Desire domain score of the IIEF (Spearman rank correlation coefficient, r = 0.50; P<.0001). CONCLUSIONS: Patients desired more prostate cancer specific survival than what was afforded by LTAD and radiotherapy compared with STAD and radiotherapy. Cancer 2010;116:1909-17.

• 出版日期2010-4-15