OBJECTIVE: To explore the therapeutic response and toxicity of neoadjuvant hormonal therapy in 125I permanent seed implantation for prostate cancer and validate the clinical efficacy of neoadjuvant hormonal therapy.
METHODS: A total of 165 patients with T1c-T3b prostate cancer received transperineal ultrasound-guided 125I permanent seed implantation and neo-adjuvant hormonal therapy (NHT). Their median age was 79 years (range: 65 - 88). They were randomized into 2 groups: group A (n = 90, 3-month NHT before 125I permanent seed implantation for prostate cancer 0 and group B (n = 75, 125I permanent seed implantation). The prostate surface antigen (PSA) response rate, the change of prostate volume and the toxicities of urinary system and sexual function were observed.
RESULTS: The median PSA decreased to 0.38 (0.01 - 6.56) µg/L from 26.50 (3.56 - 150.00) µg/L after a 3-month neoadjuvant hormonal therapy and the median prostate volume dropped from 29.33 (23.62 - 65.21) ml from 46.38 (19.28 - 128.10) ml during a follow-up period of 24 months. After brachytherapy, the PSA level was maintained at a relatively low level (median number of 0.62 µg/L and 2.56 µg/L in groups A and B respectively). And 6 and 9 patients suffered from acute urinary retention after brachytherapy in groups A and B respectively.
CONCLUSION: Neoadjuvant hormonal therapy can reduce the volume of prostate before brachytherapy and serum PSA in a short time. The toxicities of urinary system, gastrointestinal tract and sexual function should be examined by further randomized control studies. A long-term observation is needed for the PSA-free survival rate.
Written by:
Cui X, Li Q, Xu JJ, Li J, Ou TW. Are you the author?
Department of Urology, Xuanwu Hospital Affiliated to Capital Medical University, Beijing 100053, China.
Reference: Zhonghua Yi Xue Za Zhi. 2012 Oct 16;92(38):2710-2.
PubMed Abstract
PMID: 23290112
Article in Chinese.
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