Use of alpha-1 adrenoceptor antagonists in patients who underwent low-dose-rate brachytherapy for prostate cancer - a randomized controlled trial of silodosin versus naftopidil -

Abstract

BackgroundTo evaluate the effect of two different alpha-1 adrenoceptor antagonists on lower urinary tract symptoms in patients who underwent LDR-brachytherapy.MethodsA total of 141 patients who had been clinically diagnosed with localized prostate cancer and underwent LDR-brachytherapy were enrolled. Patients were randomized and allocated to two groups (silodosin 8 mg vs. naftopidil 75 mg). The primary endpoint was a change in the international prostate symptom score (IPSS) at 3 months after seed implantation. Secondary endpoints included the recovery rate of IPSS at 12 months after seed implantation, the change in IPSS and overactive bladder symptom score, uroflowmetric parameters, and frequency volume chart (FVC). To determine independent variables that can predict IPSS recovery, logistic regression analysis was carried out.ResultsThe mean change in the IPSS at 3 months after seed implantation in both groups was ⊿10.6 (naftopidil) and ⊿10.4 (silodosin), respectively. There was not a significant difference between the two groups (p=0.728). An increase in urinary frequency and a decrease in total urinated volume and mean voided volume were observed in FVC for 12 months after seed implantation. Multivariate analysis revealed that the urethral dose (UD30) was an independent predictive parameter of IPSS recovery. Patients with UD30 < 200Gy showed a higher recovery rate of IPSS at 12 months after seed implantation.ConclusionThere was no significant difference of serial change in IPSS between silodosin and naftopidil during the first year after seed implantation. A lower dose on the urethra was an independent predictor of IPSS recovery at 12 months after seed implantation.

Quality of life worsened the most severely in patients immediately after intensity-modulated radiation therapy for prostate cancer

“…We have found no reports on treatments for LUTSs after IMRT but have found some reports on treatments for LUTSs after BT. 24 , 25 Therefore, the efficacy of alpha-1 blockers or anticholinergic drugs for LUTSs during IMRT should be evaluated in the future.…”

Assessment of lower urinary symptom flare with overactive bladder symptom score and International Prostate Symptom Score in patients treated with iodine-125 implant brachytherapy: long-term follow-up experience at a single institute

“…We performed the implantation procedure as previously described [ 20 , 21 ]. The prescribed radiation dose was 145 or 160 Gy in the implantation monotherapy group and 110 Gy of radiation combined with 45 Gy of EBRT administered in 25 fractions in the combined group [ 21 ]. Of the 355 patients, 108 (30%) were treated with combined androgen depletion therapy (ADT) in which luteinizing hormone-releasing hormone agonist, anti-androgen, or a combination of the two was used.…”

Oncological outcome, complications, lower urinary tract symptoms, and health-related quality of life after low-dose-rate salvage brachytherapy for recurrent prostate cancer following primary radiotherapy: a report of 8 cases

“…We performed the ultrasound-guided implantation procedure with preplanning and real-time planning using a VariSeed 7.2 planning system (Varian Medical Systems, Palo Alto, CA, USA), and 125 I radioactive seeds (OncoSeed, GE Healthcare, Medi-Physics Inc., Arlington Heights, IL, USA) using Mick’s applicator as previously described [ 19 , 20 ]. A radiologist with expertise of urogenital diseases diagnosed prostate MRI based on quantitative T2-weighted imaging, diffusion weighted imaging (DWI), and dynamic contrast enhanced MRI.…”