Effect of Hormonal Therapy for Volume Reduction, Lower Urinary Tract Symptom Relief and Voiding Symptoms in Prostate Cancer: Leuprolide vs Goserelin
Vol. 16 No. 2 (2019),
5 May 2019
Aim. The complaints of lower urinary tract symptoms (LUTS) in cases with Prostate carcinoma (Pca) depend on coexisting benign prostate hyperplasia (BPH) or aging bladder. We aimed to investigate and compare the effect of goserelin acetate with leuprolide acetate on total prostate volume (TPV), post voiding residue (PVR), International Prostate Symptom Score (IPSS) and maximum flow rate (Qmax) reduction on cases of advanced Pca.
Methods. Patients with advanced Pca were treated with goserelin acetate (10.8 mg/3 months) or leuprolide acetate (22.5 mg/3 months) for 6 months. Changes in Prostate specific antigen (PSA), testesterone level, TPV, IPSS, PVR, and Qmax were assessed every 3 months.
Results. Fifty-one patients analyzed in this study. Mean percent decrease in PSA and testesterone from baseline to 6th month was not significantly difference between two groups (respectively; p = 0.9, p = 0.15) but TPV was reduced by -20.2 % ± 4.8 and -15.6 % ± 1.04, the median total IPSS score was decreased by -34.77 % ± 8.8 and -19.77 % ± 6.1, median Qmax increased by 45.34 % ± 10.16 and 23.21 % ± 6.93, median PVR decreased by -31.54 % ± 8.4 and -19.23 % ± 5.5, respectively for two groups (all parameters (p < 0.05))Conclusion. In this study, we observed that the improvement of voiding parameters goserelin acetate was beter than leuprolide acetate. Especially it was detected the superiority of goserelin acetate group on the reduction of TPV, PVR and IPSS. Oncological outcomes were not different in both groups.
How to Cite
Pourmand G, Safavi M, Ahmadi A et al. EPCA2.22: A Silver Lining for Early Diagnosis of Prostate Cancer. Urol J. 2016;13:2845-8.
Zorlu F, Zorlu R, Divrik RT, Eser S, Yorukoglu K. Prostate cancer incidence in Turkey: an epidemiological study. Asian Pac J Cancer Prev. 2014;15:9125-30.
Dias Silva É, Ferreira U, Matheus W et al. Goserelin versus leuprolide in the chemical castration of patients with prostate cancer. Int Urol Nephrol. 2012;44:1039-44.
Hamilton W, Sharp D. Symptomatic diagnosis of prostate cancer in primary care: a structured review. Br J Gen Pract. 2004;54:617-21.
Andersson SO, Rashidkhani B, Karlberg L, Wolk A, Johansson JE. Prevalence of lower urinary tract symptoms in men aged 45-79 years: a population-based study of 40 000 Swedish men. BJU Int. 2004;94:327-31.
Soloway MS, Hachiya T, Civantos F, Murphy WM, Gomez CC, Ruiz HE. Androgen deprivation prior to radical prostatectomy for T2b and T3 prostate cancer. Urology. 1994;43:52-6.
Washino S, Hirai M, Saito K, Kobayashi Y, Arai Y, Miyagawa T. Impact of Androgen Deprivation Therapy on Volume Reduction and Lower Urinary Tract Symptoms in Patients with Prostate Cancer. Low Urin Tract Symptoms. 2016 Dec 12. doi: 10.1111/luts.12142. [Epub ahead of print]
Sun S, Bai Y, Yang H, Yang HW. Investigation on lower urinary tract symptoms (LUTS) in elderly patients with prostate cancer (PC) received endocrine therapy. Arch Gerontol Geriatr. 2015;60:535-7. doi: 10.1016/j.archger.2014.10.014.
Stone NN, Marshall DT, Stone JJ, Cesaretti JA, Stock RG. Does neoadjuvant hormonal therapy improve urinary function when given to men with large prostates undergoing prostate brachytherapy? J Urol. 2010;183:634-9. doi: 10.1016/j.juro.2009.09.084.
Axcrona K, Aaltomaa S, da Silva CM et al. Androgen deprivation therapy for volume reduction, lower urinary tract symptom relief and quality of life improvement in patients with prostate cancer: degarelix vs goserelin plus bicalutamide. BJU Int. 2012;110:1721-8. doi: 10.1111/j.1464-410X.2012.11107.x.
Lepor H. Comparison of single-agent androgen suppression for advanced prostate cancer. Rev Urol. 2005;7 Suppl 5:S3-S12.
Kucway R, Vicini F, Huang R, Stromberg J, Gonzalez J, Martinez A. Prostate volume reduction with androgen deprivation therapy before interstitial brachytherapy. J Urol. 2002;167:2443-7.
Klarskov LL, Klarskov P, Mommsen S, Svolgaard N. Effect of endocrine treatment on voiding and prostate size in men with prostate cancer: a long-term prospective study. Scand J Urol Nephrol. 2012;46:37-43. doi: 10.3109/00365599.2011.637953.
Lehrer S, Stone NN, Droller MJ, Stock RG. Association between American Urologic Association (AUA) urinary symptom score and disease stage in men with localized prostate cancer. Urol Oncol. 2002;7:73-6.
Pinault S, Têtu B, Gagnon J, Monfette G, Dupont A, Labrie F. Transrectal ultrasound evaluation of local prostate cancer in patients treated with LHRH agonist and in combination with flutamide. Urology. 1992;39:254-61.
Whittington R, Broderick GA, Arger P et al. The effect of androgen deprivation on the early changes in prostate volume following transperineal ultrasound guided interstitial therapy for localized carcinoma of the prostate. Int J Radiat Oncol Biol Phys. 1999;44:1107-10.
Gallo CB, Miranda AF, Felix-Patricio B et al. Effects of castration and hormone replacement in the urinary bladder of rats: structural, ultrastructural, and biochemical analysis. J Androl. 2012;33:684-90. doi: 10.2164/jandrol.111.014159.
Sarosdy MF, Schellhammer PF, Sharifi R et al. Comparison of goserelin and leuprolide in combined androgen blockade therapy. Urology. 1998;52:82-8.
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