前立腺癌に対する密封小線源治療と強度変調前立腺外照射の治療後QOLの比較検討

Prospective assessment of quality of life after brachytherapy and intensive modulated radiation therapy for prostate cancer

　前立腺癌患者に対する密封小線源治療と強度変調放射線外照射（IMRT）治療の前後における生活の質（quality of life：QOL）調査を行った。密封小線源治療は137例，IMRTは28例を対象に，治療前および治療後1・3・6・12か月の縦断的調査をUCLA-PCIやI-PSSを用いて行い，比較検討した。両治療とも術後1か月でI-PSS（International Prostate Symptom Scores）の悪化を認め，また密封小線源治療ではUCLA-PCIのUB（排尿負担感）で，治療後1・3・12か月に有意差をもって悪化を認めた。性機能でIMRTのほうが密封小線源に比べ悪化していた。今後は，EPIC日本語版などの新しいQOL調査票を用いて，前立腺癌治療の影響を調べていく必要があると思われた。

　A prospective study was undertaken to evaluate the quality of life（QOL）in patients with prostate carcinoma who were treated with brachytherapy and compare these patients with patients who were treated with intensive modulated radiation therapy（IMRT）. One hundred thirty seven patients treated with brachytherapy and 28 patients treated with IMRT were prospectively administrated questionnaires including the University of California Los Angels Prostate Cancer Index（UCLA-PCI）and the International Prostate Symptoms Score（I-PSS）. Both groups showed a posttreatment decrease in I-PSS at one month, and the brachytherapy group had significantly decreased the urinary bother score at 1, 3 and 12 months compared with the baseline level. The sexual functions（SF）scores were lower in the IMRT group than in the brachytherapy group. Our results suggest that a prospective study using an EPIC Japanese version should be undertaken in future in patients with prostate carcinoma who are treated with various kinds of treatments.（Rinsho Hinyokika 61：721-728, 2007）