Presentation Authors: Yoshiyuki Miyazawa*, Akira Ohtsu, Daisuke Oka, Tomomi Saito, Hiroshi Nakayama, Sota Kurihara, Takeshi Miyao, Takahiro Syuto, Masashi Nomura, Yoshitaka Sekine, Hidekazu Koike, Hiroshi Matsui, Yasuhiro Shibata, Kazuhiro Suzuki, Maebashi, Japan
Introduction: The GnRH antagonist is an effective therapeutic method widely used for the treatment of prostate cancer, but the relationship between GnRH antagonist and serum adrenal androgen change is unclear. We have studied and reported the change of adrenal androgen in prostate cancer patients who administered GnRH antagonist (BMC Urology. 2017,17; 70). We examined the relationship between the change in adrenal androgen and the lower urinary tract symptoms of prostate cancer patients who received antagonist.
Methods: For 47 patients who were diagnosed with prostate cancer and administered GnRH antagonist at our hospital, International Prostate Symptoms Score (IPSS) change, prostate volume, and adrenal androgen levels before and after administration were examined. Adrenal androgens were examined by liquid chromatography technique coupled with tandem mass spectrometry (LC-MS/MS) method. This study was approved by the institutional review board of Gunma University Hospital (No.1261).
Results: The median age of 47 patients was 73.6Â±7.02 years (Â±S.D.) and the median initial PSA was 11.1Â±489.1 ng/ml. The mean of IPSS was significantly decreased after 1 month (8.00) and 3 months (7.13) of treatment (p < 0.05), compared with before treatment (9.62). The mean of IPSS showed a tendency to gradually rise until after 12 months (7.13 to 8.79). Prostate volume shrank 33.4Â±18.5% after 6 months and 42.3Â±18.6% after 12 months. As for adrenal androgen genes Dehydroepiandrosterone (DHEA), DHEA-Sulfate (DHEA-S) and Androstenedione (A-dione), there is a tendency that each has a significant difference in comparison before administration and after 12 months, significant positive correlation was found between the 3 groups (p < 0.001). The 47patients were divided into two groups, a group in which the adrenal androgen was widely reduced and a group in which the decrease was small. We compared the rate of change of IPSS between the two groups. IPSS was significantly lowered in cases where adrenal androgen was widely reduced (p = 0.01).
Conclusions: It is suggested that the lowering of adrenal androgen by GnRH antagonist administration may affect lower urinary tract symptoms.