Neoadjuvant Androgen Deprivation Therapy for Prostate Volume Reduction, Lower Urinary Tract Symptom Relief and Quality of Life Improvement in Men with Intermediate- to High-risk Prostate Cancer: A Randomised Non-inferiority Trial of Degarelix versus Goserelin plus Bicalutamide

A prospective, observational grouped analysis to evaluate the effect of triptorelin on lower urinary tract symptoms in patients with advanced prostate cancer

“…However, in this grouped analysis, which consisted mostly of patients receiving first-line triptorelin therapy (approximately 70% of patients), the reductions in total IPSS among those with moderate or severe LUTS appear to be at least as large as those reported among patients receiving goserelin in previous studies (mean reduction of 7.5 points in this study compared with 0.5-3.5 in the neoadjuvant setting [Mason et al 2013] and 4.5-9.6 in patients with more severe disease ). In previous studies the duration of follow up was 12 weeks, whereas our observations demonstrate that the benefits of GnRH agonists on reducing the severity of LUTS are maintained (and possibly improved) over the longer duration of 24 and 48 weeks.…”

“…Furthermore, the GnRH antagonist degarelix had a greater impact on LUTS at 12 weeks compared with the GnRH agonist goserelin, despite similar effects on PSA and testosterone suppression, which may suggest the mechanism on LUTS is independent of these markers Anderson et al 2013;Mason et al 2013;Cui et al 2014]. Although prostate volume was not measured in this observational study, there was a clear correlation between PSA suppression and LUTS improvement in this large cohort of patients.…”

“…One strength of the current analysis is that it includes a larger population than has previously been assessed for the impact of ADT on LUTS Anderson et al 2013;Mason et al 2013;Cui et al 2014], but observational studies have inherent limitations, such as potential selection bias and lack of control for confounding factors, which we acknowledge in this report. Furthermore, the IPSS relies on patient recall to rate symptoms, which could lead to under-or over-estimation of symptoms.…”

“…Differences in patient populations and settings make comparison with other recently published papers difficult Anderson et al 2013;Mason et al 2013]. However, in this grouped analysis, which consisted mostly of patients receiving first-line triptorelin therapy (approximately 70% of patients), the reductions in total IPSS among those with moderate or severe LUTS appear to be at least as large as those reported among patients receiving goserelin in previous studies (mean reduction of 7.5 points in this study compared with 0.5-3.5 in the neoadjuvant setting [Mason et al 2013] and 4.5-9.6 in patients with more severe disease ).…”

Current trends for the use of androgen deprivation therapy in conjunction with radiotherapy for patients with unfavorable intermediate‐risk, high‐risk, localized, and locally advanced prostate cancer

“…Results of a more recent study have provided additional support for this observation. 65 However, the clinical value and overall impact on QoL remains to be determined.…”