预防性A阻塞剂用于前列腺癌男性的放射治疗诱导下尿路症状:第三期随机试验
Tamim Niazi1, Edmond Kaldany1, Steven Tisseverasinghe2
1Division of Radiation Oncology, Department of Oncology, McGill University, Montreal, QC H3A 0G4, Canada.
Cancers
|July 14, 2023
概括
预防性α阻断剂在接受外部光束放射治疗的前列腺癌患者中没有显著减少辐射诱导的生殖尿路症状. 建议在症状出现时进行治疗,以避免不必要的药物暴露.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 辐射瘤学 辐射瘤学
- 药理学 药理学是指药理学的学科.
背景情况:
- 前列腺癌的外部光束放射治疗 (EBRT) 通常会导致辐射诱导的下泌尿道症状 (RI-LUTS).
- 阿尔法阻断剂经常用于控制这些症状,但它们的预防性使用仍在争论中.
研究的目的:
- 评估预防性与治疗性阿尔法阻断剂在接受EBRT的前列腺癌患者改善RI-LUTS的疗效.
- 为了比较国际前列腺症状评分 (IPSS) 在预防和治疗阿尔法阻断剂组之间的变化.
主要方法:
- 一项III期随机试验,涉及148名前列腺癌患者.
- 患者随机分配,在RI-LUTS发作时接受预防性西洛多辛或治疗.
- 使用IPSS量化LUTs,主要终点是从基线到RT的最后一天的IPSS变化.
主要成果:
- 在RT的最后一天 (p=0.40) 在预防和治疗臂之间没有观察到平均IPSS的显著差异.
- 对治疗意图的分析显示,在基线,RT结束或RT后4周和12周没有显著的IPSS差异.
- 患者人口统计学,基线IPSS和辐射剂量在各组之间得到了很好的平衡.
结论:
- 预防性α阻断剂在接受EBRT治疗的前列腺癌患者的RI-LUTS显著降低方面无效.
- 建议在RI-LUTSs开始时开始使用α-阻断剂治疗,以防止不必要的药物暴露和潜在的毒性.
- 这一发现支持一种更有针对性的方法来管理辐射诱导的尿生殖系统副作用.
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