Washino Satoshi, Hirai Masaru, Saito Kimitoshi, Kobayashi Yutaka, Arai Yoshiaki, Miyagawa Tomoaki
Department of Urology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Department of Urology, Nishiohmiya Hospital, Saitama, Japan.
Low Urin Tract Symptoms. 2018 Jan;10(1):57-63. doi: 10.1111/luts.12142. Epub 2016 Dec 12.
To evaluate the impact of androgen deprivation therapy (ADT) on prostate volume, lower urinary tract symptoms (LUTS), and LUTS-related quality of life (QOL) in patients with prostate cancer.
Patients with prostate cancer (PCa) were treated with goserelin and bicalutamide for 24 weeks. Changes in the total prostate volume (TPV), International Prostate Symptom Score (IPSS), and QOL score for urinary symptoms were assessed every 12 weeks. Of the 42 patients enrolled, 8 patients withdrew and 2 were excluded, so 32 patients were analyzed.
The median age, PSA levels, and TPV were 77.5 years, 22.0 ng/mL, and 29.5 cm , respectively. TPV showed a significant decrease from baseline in weeks 12 and 24, with the mean percent decreases being -37.5 ± 4.25 and -7.5 ± 3.84%, respectively. The IPSS decreased from baseline to weeks 12 and 24 (from 11.7 ± 1.6 to 9.3 ± 1.0 and 9.3 ± 1.0; P = 0.15 and 0.2, respectively). The IPSS voiding score showed a significant decrease from baseline to weeks 12 and 24 whereas the IPSS storage score did not. In patients with moderate to severe LUTS, the IPSS and the QOL score showed a significant decrease in weeks 12 and 24. In patients with mild LUTS, nocturia increased significantly from baseline and there was approximately one additional episode of nocturia at 24 weeks.
In this study, we observed that ADT significantly reduced TPV and improved LUTS in patients with PCa and moderate to severe LUTS, but increased nocturia in patients with mild LUTS.
评估雄激素剥夺治疗(ADT)对前列腺癌患者前列腺体积、下尿路症状(LUTS)及LUTS相关生活质量(QOL)的影响。
前列腺癌(PCa)患者接受戈舍瑞林和比卡鲁胺治疗24周。每12周评估总前列腺体积(TPV)、国际前列腺症状评分(IPSS)及尿路症状QOL评分的变化。在纳入的42例患者中,8例退出,2例被排除,因此对32例患者进行分析。
中位年龄、前列腺特异性抗原(PSA)水平和TPV分别为77.5岁、22.0 ng/mL和29.5 cm³。TPV在第12周和第24周时较基线显著降低,平均降低百分比分别为-37.5±4.25%和-7.5±3.84%。IPSS从基线至第12周和第24周有所下降(从11.7±1.6降至9.3±1.0和9.3±1.0;P值分别为0.15和0.2)。IPSS排尿评分从基线至第12周和第24周显著降低,而IPSS储尿评分未降低。在中重度LUTS患者中,IPSS和QOL评分在第12周和第24周显著降低。在轻度LUTS患者中,夜尿症较基线显著增加,且在24周时夜尿症发作次数增加约1次。
在本研究中,我们观察到ADT可显著降低PCa合并中重度LUTS患者的TPV并改善LUTS,但会增加轻度LUTS患者的夜尿症。