Degarelix as a neoadjuvant hormonal therapy for acute urinary tract toxicity associated with external beam radiotherapy for intermediate- and high-risk prostate cancer: a propensity score matched analysis

Abstract

Background In prostate cancer treatment, lower urinary tract symptoms significantly improve with luteinizing hormone-releasing hormone antagonists use compared with agonists. However, it is unclear whether luteinizing hormone-releasing hormone antagonists can decrease acute urinary tract toxicity during external beam radiotherapy. This study aimed to assess whether luteinizing hormone-releasing hormone antagonists used as neoadjuvant therapy reduced acute urinary tract toxicity during external beam radiotherapy compared with luteinizing hormone-releasing hormone agonists. Methods The study included 78 patients who underwent intensity-modulated radiation therapy for intermediate- and high-risk prostate cancer between April 2013 and January 2020. Irradiation was initiated after 3–6 months of neoadjuvant therapy. Androgen deprivation therapy was given to the intermediate-risk group for 6 months and the high-risk group for 2–3 years. The European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group toxicity grading scale was used to evaluate the urinary tract system toxicity. Relevant clinical factors were used in matching patients based on propensity scores to enable comparison between the groups. Results Each group had 27 matched patients. There was no reduction in urinary tract toxicity with the use of luteinizing hormone-releasing hormon antagonists (P = 0.624). For patients with an International Prostate Symptom Score of ≥11 at the start of treatment, 18 patients in each group were matched. Significantly lower scores were observed in the luteinizing hormone-releasing hormon antagonist group (P = 0.041). Conclusions Luteinizing hormone-releasing hormon antagonists may reduce acute urinary tract toxicity during prostate cancer external beam radiotherapy compared with luteinizing hormone-releasing hormon agonists, in particular in patients with moderate to severe symptoms at the start of treatment.

The Impact of Neoadjuvant Hormone Therapy on Surgical and Oncological Outcomes for Patients With Prostate Cancer Before Radical Prostatectomy: A Systematic Review and Meta-Analysis

“…NHT before radical prostatectomy (RP) has been reported in several trials involving patients with locally advanced PCa. In several non-randomized trials, NHT plus RP have demonstrated improvements in local control of PCa ( 6 – 9 ).…”

Efficacy of Degarelix in the Neoadjuvant Setting in Managing Locally Advanced Prostate Cancer

“…A randomized trial by Mason et al found that neoadjuvant use of degarelix before radiotherapy notably improved patient urinary symptoms compared to goserelin [ 9 ]. Hata et al also revealed that LHRH antagonists significantly mitigated acute urinary toxicities during radiation therapy [ 11 ]. In our study, all patients who received degarelix reported improvements in various symptoms, including lower urinary tract symptoms, lower back pain, and easy fatigability (subjective and hence not recorded on a formal measurement scale).…”

Effect and mechanism of paclitaxel loaded on magnetic Fe 3 O 4 @mSiO 2 -NH 2 -FA nanocomposites to MCF-7 cells

“…Breast cancer is caused by numerous factors including the environment (Cheng et al., 2022 ), heredity (Lee et al., 2022 ), and other factors (Ro et al., 2022 ). According to a summary of relevant papers published by Chinese clinicians on the treatment of breast cancer (Killelea et al., 2020 ; He et al., 2021 ), the current clinical treatment methods (Dinparvar et al., 2020 ; Liu et al., 2020 ) are mainly a combination of surgical treatment (Efetov et al., 2020 ; Jarvis et al., 2020 ; Webster et al., 2020 ) and chemotherapy (Guay et al., 2022 ; Karampinis et al., 2022 ), or radiotherapy (Yuan et al., 2020 ; Hashida et al., 2021 ; Hata et al., 2021 ; Wei et al., 2021) and targeted therapy (Chen et al., 2020 ). Currently, the chemotherapeutic drugs anthracycline and taxane are widely used in breast cancer and are the benchmark for future targeted therapies (Wala et al., 2022 ).…”