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 -

Radiation Oncology

Kiyohide Fujimoto²  Noboru Konishi³  Masatoshi Hasegawa⁴  Akihide Hirayama¹  Satoshi Anai²  Makito Miyake²  Isao Asakawa⁴  Kazumasa Torimoto²  Nobumichi Tanaka² 

[1] Department of Urology, Nara Hospital Kinki University Faculty of Medicine, Ikoma 630-0293, Nara, Japan;Departments of Urology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan;Departments of Urology and Pathology, Nara Medical University, Kashihara 634-8522, Nara, Japan;Radiation Oncology, Nara Medical University, Kashihara 634-8522, Nara, Japan

关键词: Randomized controlled study;    Urinary morbidity;    Alpha-1 adrenoceptor antagonist;    LDR-brachytherapy;    Prostate cancer;   

Others  :  1150299
DOI  :  10.1186/s13014-014-0302-7

 received in 2014-10-23, accepted in 2014-12-14,  发布年份 2014

【 摘 要 】

Background

To evaluate the effect of two different alpha-1 adrenoceptor antagonists on lower urinary tract symptoms in patients who underwent LDR-brachytherapy.

Methods

A 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.

Results

The 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.

Conclusion

There 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.

【 授权许可】

   
2014 Tanaka et al.; licensee BioMed Central.

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