Document Detail


Efficacy of selective alpha-1 blocker therapy in the treatment of acute urinary symptoms during radiotherapy for localized prostate cancer.
MedLine Citation:
PMID:  10524407     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
M J Zelefsky; R X Ginor; Z Fuks; S A Leibel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  1999-10-27     Completed Date:  1999-10-27     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  567-70     Citation Subset:  IM    
Affiliation:
Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic alpha-Antagonists / 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:
0/Adrenergic alpha-Antagonists; 0/Anti-Inflammatory Agents, Non-Steroidal; 19216-56-9/Prazosin; 63590-64-7/Terazosin

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