Shimizu Nobutaka, Minami Takafumi, Sugimoto Koichi, Saito Yoshitaka, Yamamoto Yutaka, Hayashi Taiji, Tsuji Hidenori, Nozawa Masahiro, Yoshimura Kazuhiro, Ishii Tokumi, Uemura Hirotsugu, Nakamatsu Kiyoshi
Department of Urology, Faculty of Medicine, Kinki University, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan,
World J Urol. 2014 Dec;32(6):1423-32. doi: 10.1007/s00345-014-1239-z. Epub 2014 Jan 17.
The purpose of the study is to investigate the efficacy of an alpha-1 adrenergic receptor antagonist (silodosin) for the treatment of lower urinary tract symptoms (LUTS) associated with interstitial (125)I implantation for prostate cancer.
This randomized single-center study involved 105 patients (53 with and 52 without silodosin). Silodosin was postoperatively administered, daily, for 6 months (8 mg/day). Urinary symptoms and pressure flow were evaluated preoperatively and postoperatively at 1, 3, 6, and 12 months.
At 12 months, interstitial (125)I implantation had induced a significant decrease in prostate volume (28.3 ± 11.1-20.5 ± 8.1 g in the silodosin group and 26.1 ± 9.7-17.7 ± 4.9 g in the controls) and the prostate-specific antigen level (7.1 ± 3.6-1.4 ± 1.7 ng/mL in the silodosin group and 8.1 ± 4.3-1.3 ± 1.2 ng/mL in the controls). Significant improvements in the international prostate symptom voiding subscores at 6 months and quality of life at 3 months were observed in those receiving silodosin. The pressure flow studies demonstrated that silodosin had significantly enlarged the bladder capacity when the first non-voiding contraction was seen at 3 and 12 months (3M: 127.1 ± 74.8 vs. 118.2 ± 83.9 mL, p = 0.001; 12M: 123.7 ± 79.3 vs. 100.3 ± 73.4 mL, p = 0.01); however, there were no improvements in the bladder outlet obstruction index (BOOI) or urinary flow.
Silodosin temporarily improved LUTS, but did not improve the BOOI after (125)I implantation in the prostate.
本研究旨在探讨α-1肾上腺素能受体拮抗剂（西洛多辛）治疗前列腺癌间质（125）I植入术后相关下尿路症状（LUTS）的疗效。
这项随机单中心研究纳入了105例患者（53例服用西洛多辛，52例未服用）。术后每天给予西洛多辛，持续6个月（8毫克/天）。术前及术后1、3、6和12个月评估泌尿症状和压力流情况。
12个月时，间质（125）I植入使前列腺体积显著减小（西洛多辛组从28.3±11.1克降至20.5±8.1克，对照组从26.1±9.7克降至17.7±4.9克），前列腺特异性抗原水平也显著降低（西洛多辛组从7.1±3.6纳克/毫升降至1.4±1.7纳克/毫升，对照组从8.1±4.3纳克/毫升降至1.3±1.2纳克/毫升）。服用西洛多辛的患者在6个月时国际前列腺症状排尿子评分及3个月时生活质量有显著改善。压力流研究表明，在3个月和12个月首次出现非排尿收缩时，西洛多辛显著增大了膀胱容量（3个月时：127.1±74.8毫升对118.2±83.9毫升，p = 0.001；12个月时：123.7±79.3毫升对100.3±73.4毫升，p = 0.01）；然而，膀胱出口梗阻指数（BOOI）或尿流并无改善。
西洛多辛可暂时改善LUTS，但前列腺（125）I植入术后并不能改善BOOI。
