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.
Highlights
To evaluate the effect of two different alpha-1 adrenoceptor antagonists on lower urinary tract symptoms in patients who underwent LDR-brachytherapy
In this study we evaluate the efficacy of two alpha-1 adrenoceptor antagonists for subtypes 1A and 1D in patients who underwent LDR-brachytherapy and present the urinary adverse events
Of 170 patients who were clinically diagnosed with localized prostate cancer and underwent LDR-brachytherapy between July 2007 and April 2010, the 141 patients who provided written informed consent were enrolled in this prospective randomized study
Summary
To evaluate the effect of two different alpha-1 adrenoceptor antagonists on lower urinary tract symptoms in patients who underwent LDR-brachytherapy. The most common adverse events of LDR-brachytherapy are urinary frequency and urgency [6,7,8]. More than 50% patients show urinary frequency and urgency for 6 months after seed implantation. An alpha-1 adrenoceptor antagonist is used to prevent and relieve these symptoms, the efficacy on these adverse events has not been assessed sufficiently. Three subtype alpha-1 adrenoceptors are alpha-1A, alpha-1B and alpha-1D. Of these different subtypes, alpha-1A and alpha-1D receptors are predominantly found in the bladder and prostatic urethra [9]. Alpha-1 adrenoceptor antagonist is commonly used to improve
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