Quantifying the change in endorectal magnetic resonance imaging-defined tumor volume during neoadjuvant androgen suppression therapy in patients with prostate cancer.
OBJECTIVE
To quantify the changes seen in the endorectal magnetic resonance imaging (erMRI)-defined prostate volume, predominant tumor volume, and secondary tumor volume during neoadjuvant total androgen suppression (TAS).


METHODS
Between July 1997 and April 2001, 152 consecutive patients with clinical Stage T1b-T3cNXM0 prostate cancer were treated with 6 months of TAS and external beam radiotherapy. erMRI was conducted before and after 2 months of neoadjuvant TAS. The median values and percentage of changes in the erMRI-measured prostate volume and primary and secondary tumor volumes during neoadjuvant TAS were calculated and compared, using the Wilcoxon matched-pairs signed-rank method, for the patients overall and stratified by pretreatment risk group.


RESULTS
All patients had a significant decline in their erMRI-defined median prostate volume (36.6 versus 25.7 cm(3), P <0.0001) during 2 months of neoadjuvant TAS. The median primary tumor volume decreased significantly in the intermediate-risk (0.77 versus 0.52 cm(3), P <0.0001) and high-risk (2.48 versus 0.83 cm(3), P <0.0001) patients. The median secondary tumor volume approached a significant decline in only the high-risk patients (0.45 versus 0.31 cm(3), P = 0.15). Fourteen percent of patients had an increase in their primary tumor volume during neoadjuvant TAS.


CONCLUSIONS
The erMRI-defined primary and secondary tumor volumes generally decreased in the study population during neoadjuvant TAS. However, 14% of patients had an increase in their primary tumor volume during androgen suppression therapy. The clinical significance of this awaits further study.
Sanghani
Mona V
MV
Department of Radiation Oncology, Brigham and Women's Hospital and Dana Farber Cancer Institute, Boston, Massachusetts 02115, USA.
Schultz
Delray
D
Tempany
Clare M
CM
Titelbaum
David
D
Renshaw
Andrew A
AA
Loffredo
Marian
M
Cote
Kerri
K
McMahon
Beth
B
D'Amico
Anthony V
AV
D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000532:radiotherapy; D018714:Radiotherapy, Adjuvant; D011966:Receptors, LHRH / Q000819:agonists
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D011966:Receptors, LHRH