Presentation Authors: Tomohiko Oguchi*, Nagano, Japan, Tomonori Minagawa, Ayumu Fukasawa, Matsumoto, Japan, Kazuyoshi Iijima, Nagano, Japan, Keiichiro Koiwai, Matsumoto, Japan, Iwao Hashida, Nagano, Japan, Teruyuki Ogawa, Matsumoto, Japan, Haruaki Kato, Nagano, Japan, Osamu Ishizuka, Matsumoto, Japan
Introduction: Lower urinary tract symptoms (LUTS) is a common adverse event in the acute phase after low dose rate brachytherapy (LDR) for prostate cancer. In addition, erectile dysfunction (ED) might be also problematic in the chronic phase after LDR. Alpha blockers have positive impact on LUTS after LDR. Nowadays, usefulness of tadalafil (TAD), a phosphodiesterase-5 inhibitor, was established as a treatment for male LUTS and ED. Although TAD may be theoretically useful for management of LUTS and ED after LDR, usefulness of TAD after LDR has not been reported yet. We herein investigated the efficacy of TAD to attenuate adverse events after LDR comparing tamuslosin (TAM), an alpha blocker.
Methods: This study was a multicenter randomized open-label trial, and was conducted at 2 hospitals in Japan. Inclusion criteria of this study is the prostate cancer patients, who were 80 years or less, T2 or less, prostate specific antigen (PSA) 10 ng/mL or less, Gleason score 3+4 or less. They were randomly divided into 2 groups, the TAM group (0.2mg/day) and the TAD group (5mg/day). TAM and TAD were administrated from the day following LDR. PSA, international prostate symptom score (IPSS), quality-of-life (QoL) score, overactive bladder symptom score (OABSS), international index of erectile function (IIEF5), were evaluated before and 1, 3, 6, 9, 12 months after LDR. Uroflowmetry and residual urine volume were also evaluated.
Results: A total of 107 patients were enrolled in this study. Finally, 96 patients were analyzed. There was no significant difference in the patient background among the groups. The summarized results were shown in Table. Improvement of IPSS in TAM group is better than TAD group, and IIEF5 in TAD group is better than TAM group 9 months after LDR. However, general course of LUTS and ED in TAD group is almost similar to TAM group during 1 year follow up. And, there are no statistical differences of the objective findings among the groups.
Conclusions: TAD can be a treatment option for management of LUTS and ED after LDR comparable to TAM.