Kyoda Yuki, Hashimoto Kohei, Takahashi Atsushi, Maehana Takeshi, Tachikawa Kimihito, Muranaka Takashi, Kato Shuichi, Kurisu Tomoyo, Fukuta Fumimasa, Kirisawa Takahiro, Okada Manabu, Kobayashi Ko, Tanaka Toshiaki, Hinotsu Shiro, Masumori Naoya
Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan.
Department of Urology, Hakodate Goryoukaku Hospital, Hakodate, Japan.
Curr Urol. 2024 Jun;18(2):122-127. doi: 10.1097/CU9.0000000000000194. Epub 2024 Jun 21.
We clarified the predictive factors for changes in the status of medications for lower urinary tract symptoms (LUTS) 2 years after local radiotherapy for nonmetastatic prostate cancer.
We retrospectively included patients who underwent local external radiotherapy for nonmetastatic prostate cancer in 8 institutions between April 2001 and March 2016. Patients were divided into the medication and no-medication group based on the use of drugs for LUTS before radiotherapy. We defined improvement of LUTS as when the patient did not require medication for LUTS at 24 months after radiotherapy in the medication group and as deterioration when medication was required in the no-medication group. Logistic regression analysis was used to evaluate predictive factors for changes in medication status.
Altogether, 505 patients were divided into a no-medication group (n = 352) and a medication group (n = 153). The number of patients with deterioration and improvement in LUTS was 49 (14%) and 36 (23%), respectively. In the multivariate analysis, the predictive variables for deterioration were the International Prostate Symptom Score (≥8; odds ratio [OR], 2.21; = 0.014) and the biopsy Gleason score (≤3 + 4 = 7; OR, 2.430; = 0.008) in the no-medication group, whereas those for improvement were age (<75 years old; OR, 5.81; = 0.002), the quality of life score (<3; OR, 3.15; = 0.028), and a positive biopsy core rate (≥50%; OR, 2.530; = 0.027) in the medication group.
These predictive factors for changes in the status of medications for LUTS at 2 years after external radiotherapy may help determine the definitive therapy for nonmetastatic prostate cancer.
我们明确了非转移性前列腺癌局部放疗2年后下尿路症状（LUTS）用药状态变化的预测因素。
我们回顾性纳入了2001年4月至2016年3月期间在8家机构接受非转移性前列腺癌局部外照射放疗的患者。根据放疗前是否使用LUTS药物，将患者分为用药组和不用药组。我们将LUTS的改善定义为用药组放疗后24个月患者无需使用LUTS药物，将恶化定义为不用药组需要用药。采用逻辑回归分析评估用药状态变化的预测因素。
总共505例患者被分为不用药组（n = 352）和用药组（n = 153）。LUTS恶化和改善的患者数量分别为49例（14%）和36例（23%）。在多变量分析中，不用药组中LUTS恶化的预测变量为国际前列腺症状评分（≥8；比值比[OR]，2.21；P = 0.014）和活检Gleason评分（≤3 + 4 = 7；OR，2.430；P = 0.008），而用药组中LUTS改善的预测变量为年龄（<75岁；OR，5.81；P = 0.002）、生活质量评分（<3；OR，3.15；P = 0.028）和阳性活检核心率（≥50%；OR，2.530；P = 0.027）。
这些外照射放疗2年后LUTS用药状态变化的预测因素可能有助于确定非转移性前列腺癌的最终治疗方案。
