Bicalutamide alone prior to brachytherapy achieves cytoreduction that is similar to luteinizing hormone-releasing hormone analogues with less patient-reported morbidity
| Autor: | Irving D. Kaplan, W. S. Kiger, Solomon Berg, Clifford Gluck, Edward J. Holupka, Carol Karasiewicz, James A. Talcott, D. Laury Henry, Joshua H. Petit |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty Antineoplastic Agents Hormonal Bicalutamide medicine.drug_class Urology medicine.medical_treatment Urinary system Brachytherapy Antiandrogen law.invention Tosyl Compounds Prostate cancer Randomized controlled trial law Prostate Nitriles medicine Humans Anilides Aged Aged 80 and over business.industry Prostatic Neoplasms Androgen Antagonists Middle Aged medicine.disease Combined Modality Therapy Surgery Radiation therapy medicine.anatomical_structure Oncology Goserelin Leuprolide Morbidity business medicine.drug |
| Zdroj: | Urologic Oncology: Seminars and Original Investigations. 26:372-377 |
| ISSN: | 1078-1439 |
| DOI: | 10.1016/j.urolonc.2007.05.014 |
| Popis: | To compare the impact of bicalutamide (B) vs. luteinizing hormone-releasing hormone analogues (LHRHa) on prostate volume, patient-reported side effects, and postimplant urinary toxicity in the setting of interstitial brachytherapy for early-stage prostate cancer.Between May 1998 and January 2004, 81 patients received androgen-deprivation therapy (ADT) for cytoreduction prior to interstitial brachytherapy alone. Fifty-six patients received LHRHa and 25 patients received B. Prostate volumes were measured prospectively prior to initiating therapy, and then intraoperatively at the time of implant by a single, blinded ultrasonographer. Patient-reported quality of life data were obtained prospectively, and postimplant urinary toxicity (catheter dependency and need for surgical intervention) was recorded during follow-up. Median follow-up was 53 (range 23-78) months.The median percentage prostate volume reductions of 26% for B and 32% for LHRHa were not statistically different (P = 0.61). Decrements in libido (92% vs. 44%, P0.001) and erectile function (79% vs. 20%) were reported in more respondents treated with LHRHa than B. The incidence of recatheterization (28% vs. 24%, P = 0.34), and the need for subsequent surgical intervention (11% vs. 4%, P = 0.16) were similar for patients treated with LHRHa and B.The degree of prostate downsizing with B is similar to that achieved with LHRHa. B was associated with fewer patient-reported sexual side effects and similar urinary morbidity. A randomized trial is needed to establish whether LHRHa or B should be the standard of care for prostate downsizing before interstitial brachytherapy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect