| Efficacy of selective alpha-1 blocker therapy in the treatment of acute urinary symptoms during radiotherapy for localized prostate cancer. | |
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MedLine Citation:
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PMID: 10524407 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To determine the efficacy of an alpha-1 adrenoreceptor blocking agent for acute urinary symptoms in patients treated with radiotherapy for localized prostate cancer. METHODS AND MATERIALS: Between 1987 and 1995, 743 patients with clinically localized prostate cancer were treated with 3D-CRT. A total of 275 (37%) patients developed Grade 2 acute urinary symptoms as defined by the RTOG morbidity scoring system. Terazosin hydrochloride (THC), a selective alpha-1 adrenoceptor blocking agent, was given to 119 (43%) patients for treatment of their urinary symptoms, whereas nonsteroidal anti-inflammatory medications (NSAID) were administered to 71 patients (26%). Thirty-one patients (11%) were treated with other medications, and 54 (20%) did not seek pharmacologic intervention for their urinary symptoms. Patients were monitored weekly to assess changes in urinary urgency, frequency, and nocturia. RESULTS: Treatment with THC resulted in a significant resolution of urinary symptoms in 79 of 119 patients (66%), while 26 (22%) had moderate improvement, and 14 (12%) had minimal to no response to this drug. In contrast, only 11 of 71 (16%) of the patients treated with NSAIDs experienced significant symptom relief, 20 (28%) had moderate improvement, and 40 (56%) had minimal to no response. The difference in the significant symptomatic improvement between THC and NSAID therapy (66% vs. 16%) was highly significant (p < 0.001). For patients treated with THC, a higher likelihood of significant symptom relief was observed in patients who did not receive neoadjuvant androgen ablation (p = 0.04) and in those who were younger than 65 years of age (p = 0.02). CONCLUSION: Alpha-1 selective adrenoceptor blocking agents are effective in ameliorating the acute urinary symptoms in patients receiving radiotherapy for localized prostate cancer. Although this was not a randomized prospective study, the data suggest that NSAIDs were less effective in relieving radiation-induced urinary symptoms. |
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Authors:
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M J Zelefsky; R X Ginor; Z Fuks; S A Leibel |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: International journal of radiation oncology, biology, physics Volume: 45 ISSN: 0360-3016 ISO Abbreviation: Int. J. Radiat. Oncol. Biol. Phys. Publication Date: 1999 Oct |
Date Detail:
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Created Date: 1999-10-27 Completed Date: 1999-10-27 Revised Date: 2009-11-19 |
Medline Journal Info:
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Nlm Unique ID: 7603616 Medline TA: Int J Radiat Oncol Biol Phys Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 567-70 Citation Subset: IM |
Affiliation:
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Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic alpha-Antagonists
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therapeutic use* Aged Aged, 80 and over Anti-Inflammatory Agents, Non-Steroidal / therapeutic use Humans Male Middle Aged Prazosin / analogs & derivatives*, therapeutic use Prostatic Neoplasms / pathology, radiotherapy* Radiation Injuries / drug therapy* Radiotherapy, Conformal Retrospective Studies Urination Disorders / drug therapy*, etiology |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic alpha-Antagonists; 0/Anti-Inflammatory Agents, Non-Steroidal; 19216-56-9/Prazosin; 63590-64-7/Terazosin |
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