UTICAJ ANDROGENE DEPRIVACIONE TERAPIJE I OTVORENE RADIKALNE RETROPUBIČNE PROSTATEKTOMIJE NA SIMPTOME U DONJEM URINARNOM TRAKTU KOD BOLESNIKA SA KARCINOMOM PROSTATE
Sažetak
Cilj ove studije bio je da se prikaže uticaj otvorene radikalne prostatektomije (engl. open radical prostatectomy – ORP) i primarne hormonoterapije na simptome donjeg urinarnog trakta (engl. lower urinary tract symptoms – LUTS) i na kvalitet života (engl. quality of life – QoL) u vezi sa ovim simptomima na osnovu Internacionalnog prostata simptom skora (engl. International Prostate Symptom Score – IPSS).
Analizirano je 128 bolesnika sa lokalizovanim karcinomom prostate, podeljenih u dve grupe. Prvu grupu činili su ispitanici koji su podvrgnuti ORP-u, a drugu grupu ispitanici koji su primarno lečeni hormonoterapijom u trajanju od dvanaest meseci. Za procenu uticaja ORP-a i hormonoterapije na LUTS i QoL korišćeni su upitnici IPSS i IPSSQoL, i to pre početka lečenja i nakon tri meseca, šest meseci i dvanaest meseci od početka lečenja.
U obema grupama ispitanika IPSSt skor konstatno se statistički značajno smanjivao u periodu praćenja u odnosu na bazičnu vrednost (p < 0,001 za sve). Nakon dvanaest meseci, IPSSt i IPSSv bili su značajno veći u grupi na hormonoterapiji nego u ORP grupi (p < 0,001), a IPSSs je bio značajno veći u ORP grupi nego u grupi bolesnika lečenih hormonoterapijom. U obema grupama ispitanika IPSSQoL se konstatno značajno smanjivao u periodu praćenja (p < 0,001). IPSSQoL je bio značajno viši u ORP grupi nego u grupi bolesnika lečenih hormonoterapijom, i to pre početka lečenja (p < 0,001), nakon tri meseca (p = 0,003) i nakon šest meseci (p = 0,002).
ORP i hormonoterapija su kao primarne metode lečenja bolesnika sa lokalizovanim PC-om dovele do statistički značajnog pada IPSS skorova i klinički značajnog poboljšanja LUTS-a. Takođe, QoL u vezi sa LUTS-om značajno se popravio nakon dvanaest meseci u obema grupama ispitanika.
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