Intra-rectal use of epinephrine in radiotherapy of prostate cancer
| Autor: | Dong-Liang Hou, Xianshu Gao, Shangbin Qin, Wei-Dong Nian, Dian Wang, Chao-Xing Liu, X.Y. Li, Hongzhen Li |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty business.industry medicine.medical_treatment Urology medicine.disease Placebo law.invention Radiation therapy 03 medical and health sciences Prostate cancer Exact test 030104 developmental biology 0302 clinical medicine Epinephrine Blood pressure Oncology Randomized controlled trial law 030220 oncology & carcinogenesis Rectal administration medicine business medicine.drug |
| Zdroj: | Cancer Management and Research. 11:4847-4854 |
| ISSN: | 1179-1322 |
| DOI: | 10.2147/cmar.s187049 |
| Popis: | Purpose: The aim of the study was to evaluate the feasibility and toxicity of intra-rectal epinephrine during prostatic radiotherapy. Materials and methods: A total of 34 patients with prostate cancer were randomized to receive daily intra-rectal epinephrine (4 mg in 40 mL, n=16) or placebo (40 mL normal saline, n=18) 5 min before daily radiotherapy. Physical examination including systolic blood pressure (SBP) and heart rate (HR) was performed before, 5 min after, and 20 min after intra-rectal use. Toxicities were graded using the Radiation Therapy Oncology Group standard. A two-sided Fisher's exact test was used to compare proportions between groups. A mixed-effects model was used to analyze multiple measurements of SBP and HR. Survival curves were calculated using the Kaplan-Meier method and compared between groups using the log-rank test. Results: All patients completed the protocol treatment and reported no cardiovascular symptoms after intra-rectal administration. There were no differences in SBP and HR between these two groups at any time point (before, 5 min after, and 20 min after epinephrine). At 5 weeks after the start of radiotherapy, the incidence of rectal toxicity≥grade 2 was 27.8% (5/18) for the control group versus 12.5% (2/16) for the epinephrine group, but was not statistically significant (p=0.4). There was no rectal toxicity≥grade 2 in these two groups beyond 2-year follow-up. The 5-year biochemical relapse-free survival was 75.0% and 72.2% for the epinephrine and control group, respectively. Conclusion: Results of this pilot randomized trial have demonstrated that intra-rectal administration of epinephrine is feasible and safe in prostatic radiotherapy. Its radio-protective effect warrants further investigation. |
| Databáze: | OpenAIRE |
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