Zhang Tong, Wu Haihu, Liu Shuai, He Wei, Ding Kejia
Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jingwu Road 324, Jinan, 250021, People's Republic of China.
Int Urol Nephrol. 2017 Jul;49(7):1111-1117. doi: 10.1007/s11255-017-1591-1. Epub 2017 Apr 13.
To assess the effectiveness and safety of tamsulosin combined with androgen deprivation therapy (ADT) for lower urinary tract symptoms (LUTS) in advanced prostate cancer (PC) patients.
Ninety PC patients with moderate-to-severe LUTS randomized into two groups of 45 each. One group received ADT (group 1), and the other received ADT plus tamsulosin (group 2) for 24 weeks. The outcome measures were changes in the International Prostate Symptom Score (IPSS), IPSS obstructive and irritative subscores, quality of life (QoL), maximum urinary flow rate (Q ), post-voiding residual (PVR) and prostate-specific antigen (PSA) from baseline. The treatment response was monitored at 8, 16 and 24 weeks.
Both ADT monotherapy and ADT plus tamsulosin significantly improved IPSS,QoL score, Q and PVR at the end of the treatment period. ADT plus tamsulosin had a greater impact on total IPSS, IPSS obstructive subscore, QoL and PVR at week 8 and week 16 than ADT monotherapy. Tamsulosin group showed greater improvement in Q than ADT group. Significant improvements of IPSS, IPSS obstructive subscore and QoL were achieved at early treatment stage (week 8) in group 2, whereas similar improvements were achieved at week 16 in group 1. There were no significant differences in IPSS, IPSS subscores, QoL and PVR between the two groups at week 24.
Additional administration of tamsulosin showed significantly greater and sooner relief in LUTS than ADT monotherapy, with good acceptability. It is feasible that ADT is used alone after 16-24 weeks of combination therapy.
评估坦索罗辛联合雄激素剥夺疗法(ADT)治疗晚期前列腺癌(PC)患者下尿路症状(LUTS)的有效性和安全性。
90例中重度LUTS的PC患者随机分为两组,每组45例。一组接受ADT(第1组),另一组接受ADT联合坦索罗辛(第2组),治疗24周。观察指标为国际前列腺症状评分(IPSS)、IPSS梗阻性和刺激性子评分、生活质量(QoL)、最大尿流率(Q)、排尿后残余尿量(PVR)以及前列腺特异性抗原(PSA)相对于基线的变化。在第8、16和24周监测治疗反应。
治疗期末,ADT单药治疗和ADT联合坦索罗辛均显著改善了IPSS、QoL评分、Q和PVR。在第8周和第16周时,ADT联合坦索罗辛对总IPSS、IPSS梗阻性子评分、QoL和PVR的影响大于ADT单药治疗。坦索罗辛组的Q改善程度大于ADT组。第2组在治疗早期(第8周)IPSS、IPSS梗阻性子评分和QoL显著改善,而第1组在第16周时取得类似改善。两组在第24周时IPSS、IPSS子评分、QoL和PVR无显著差异。
与ADT单药治疗相比,额外给予坦索罗辛在缓解LUTS方面显著更大且更快,且耐受性良好。联合治疗16 - 24周后单独使用ADT是可行的。