Hayakawa Nozomi, Mizuno Ryuichi, Tanaka Tomoki, Shiraishi Yutaka, Matsumoto Kazuhiro, Kosaka Takeo, Kikuchi Eiji, Oya Mototsugu
Department of Urology, Keio University, School of Medicine, Tokyo, Japan.
Department of Urology, St. Marianna University, School of Medicine, Kanagawa, Japan.
Prostate Int. 2024 Dec;12(4):231-237. doi: 10.1016/j.prnil.2024.09.004. Epub 2024 Oct 1.
Adverse events, such as erectile dysfunction (ED) and lower urinary tract symptoms (LUTS), are significant concerns in prostate cancer (PCa) patients treated with Iodine 125 (I-125) low-dose rate (LDR) prostate brachytherapy (PB). Alpha antagonists and phosphodiesterase-5 inhibitors are used to manage these events. The present study compared the efficacy of low-dose tadalafil with that of tamsulosin for concomitant ED and LUTS in PCa patients treated with I-125 LDR PB.
One hundred and seventeen patients who received PB for low- or intermediate-risk localized PCa were analyzed. They were randomized into two groups, one receiving tamsulosin ( = 58) and the other receiving low-dose tadalafil ( = 59) immediately after PB. Sexual and urinary functions were assessed at various time points post-PB using questionnaires and objective measurements. The primary endpoint was sexual function measured by the International Index of Erectile Function-15 (IIEF-15) EF domain scores 6 months after PB. Secondary endpoints were sexual function measured by total IIEF-15 scores and Erection Hardness Scores 6 months after PB. The exploratory endpoint was the LUTS status 6 months after PB.
No significant differences were observed in baseline characteristics between the two groups. Tadalafil exerted stronger effects on sexual function, particularly erection hardness, than tamsulosin. No significant differences were observed in the management of LUTS between both treatments.
Low-dose tadalafil and tamsulosin may manage LUTS equally after PB. Low-dose tadalafil may contribute to the maintenance of erectile function, particularly erection hardness, after PB; therefore, it is a viable option for patients with baseline erectile function.
不良事件，如勃起功能障碍（ED）和下尿路症状（LUTS），是接受碘125（I-125）低剂量率（LDR）前列腺近距离放射治疗（PB）的前列腺癌（PCa）患者的重大关切问题。α受体拮抗剂和磷酸二酯酶-5抑制剂用于处理这些事件。本研究比较了低剂量他达拉非与坦索罗辛对接受I-125 LDR PB治疗的PCa患者并发ED和LUTS的疗效。
分析了117例接受PB治疗低危或中危局限性PCa的患者。他们被随机分为两组，一组在PB后立即接受坦索罗辛（n = 58），另一组接受低剂量他达拉非（n = 59）。在PB后的不同时间点，使用问卷和客观测量方法评估性功能和排尿功能。主要终点是PB后6个月通过国际勃起功能指数-15（IIEF-15）EF领域评分测量的性功能。次要终点是PB后6个月通过IIEF-15总分和勃起硬度评分测量的性功能。探索性终点是PB后6个月的LUTS状态。
两组之间的基线特征未观察到显著差异。与坦索罗辛相比，他达拉非对性功能，特别是勃起硬度的影响更强。两种治疗在LUTS管理方面未观察到显著差异。
低剂量他达拉非和坦索罗辛在PB后对LUTS的管理效果可能相同。低剂量他达拉非可能有助于在PB后维持勃起功能，特别是勃起硬度；因此，对于基线勃起功能的患者来说，它是一个可行的选择。
