Dose Concomitant Use of Ketamine During Prostate Brachytherapy Augment Anti-Neoplastic Effects Reducing Prostate Specific Antigen?

Abstract

Background: Previous studies have demonstrated Ketamine to induced apoptosis in various cellular lines. Ketamine is commonly utilized during total intravenous anesthesia in patients undergoing brachytherapy for prostate cancer. The primary aim of this study was to determine if concomitant ketamine exposure during prostate brachytherapy improved outcomes evaluate through follow prostate specific antigen (PSA) levels. Methods: A retrospective analysis of 91 prostate brachytherapy performed at our institution from 2014-2016 was done identifying 31 procedures in which ketamine was administered during the procedure. Measured outcomes were the comparison reduction of PSA levels at 1 month, 6 months, and 12 months post procedural visits. Results: No statistical significant reduction in the prostatic specific antigen or the corresponding percent reduction of PSA levels were demonstrated between ketamine and non-ketamine exposed patient undergoing prostate brachytherapy. Conclusions: Concomitant ketamine exposure does not appear to enhance the therapeutic effect of prostate brachytherapy. When comparing the overall percent reduction of PSA levels between the two groups (ketamine exposed/ no exposure), the ketamine patients did have greater decrease in PSA levels, but was not statistically significant. With the limitation of our retrospective analysis, further double blinded prospective trials may be warranted.