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Degarelix as a neoadjuvant hormonal therapy for acute urinary tract toxicity associated with external beam radiotherapy for intermediate- and high-risk prostate cancer: a propensity score matched analysis.

Degarelix作为一种新辅助激素治疗与外照射放射治疗中高危前列腺癌相关的急性尿路毒性: 倾向评分匹配分析。

  • 影响因子:2.04
  • DOI:10.1093/jjco/hyaa163
  • 作者列表:"Hata S","Shin T","Abe S","Kawano K","Sato R","Kai T","Shibuya T","Ando T","Mimata H
  • 发表时间:2021-03-03
Abstract

BACKGROUND:In prostate cancer treatment, lower urinary tract symptoms significantly improve with luteinizing hormone-releasing hormone antagonists use compared with agonists. However, it is unclear whether luteinizing hormone-releasing hormone antagonists can decrease acute urinary tract toxicity during external beam radiotherapy. This study aimed to assess whether luteinizing hormone-releasing hormone antagonists used as neoadjuvant therapy reduced acute urinary tract toxicity during external beam radiotherapy compared with luteinizing hormone-releasing hormone agonists. METHODS:The study included 78 patients who underwent intensity-modulated radiation therapy for intermediate- and high-risk prostate cancer between April 2013 and January 2020. Irradiation was initiated after 3-6 months of neoadjuvant therapy. Androgen deprivation therapy was given to the intermediate-risk group for 6 months and the high-risk group for 2-3 years. The European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group toxicity grading scale was used to evaluate the urinary tract system toxicity. Relevant clinical factors were used in matching patients based on propensity scores to enable comparison between the groups. RESULTS:Each group had 27 matched patients. There was no reduction in urinary tract toxicity with the use of luteinizing hormone-releasing hormon antagonists (P = 0.624). For patients with an International Prostate Symptom Score of ≥11 at the start of treatment, 18 patients in each group were matched. Significantly lower scores were observed in the luteinizing hormone-releasing hormon antagonist group (P = 0.041). CONCLUSIONS:Luteinizing hormone-releasing hormon antagonists may reduce acute urinary tract toxicity during prostate cancer external beam radiotherapy compared with luteinizing hormone-releasing hormon agonists, in particular in patients with moderate to severe symptoms at the start of treatment.

摘要

背景: 在前列腺癌治疗中,与激动剂相比,使用促黄体生成素释放激素拮抗剂可显著改善下尿路症状。然而,目前尚不清楚促黄体生成素释放激素拮抗剂是否可以减少外照射放疗期间的急性尿路毒性。本研究旨在评估与促黄体生成素释放激素激动剂相比,作为新辅助治疗的促黄体生成素释放激素拮抗剂是否减少了外照射放疗期间的急性尿路毒性。 方法: 本研究纳入了78例在2013年4月至2020年1月间接受调强放疗的中高危前列腺癌患者。新辅助治疗3-6个月后开始放疗。中危组给予雄激素剥夺治疗6个月,高危组给予2 ~欧洲癌症研究和治疗组织/放射疗法肿瘤学组毒性分级量表用于评价泌尿道系统毒性。相关临床因素用于基于倾向评分匹配患者,以实现组间比较。 结果: 每组有27名匹配的患者。使用促黄体生成素释放激素拮抗剂没有减少尿路毒性 (P = 0.624)。对于治疗开始时国际前列腺症状评分 ≥ 11分的患者,每组匹配18例。在促黄体生成素释放激素拮抗剂组中观察到显著较低的评分 (P = 0.041)。 结论: 与促黄体激素释放激素激动剂相比,促黄体激素释放激素拮抗剂可减轻前列腺癌外照射放疗期间的急性尿路毒性,特别是在治疗开始时有中度至重度症状的患者中。

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影响因子:2.68
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DOI:10.1007/s11033-021-06299-9
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