Efficacy and tolerability of radiotherapy as treatment for bicalutamide-induced gynaecomastia and breast pain in prostate cancer.
OBJECTIVE
To assess the efficacy and tolerability of localised radiotherapy for the treatment of bicalutamide ('Casodex''Casodex' is a trademark of the AstraZeneca group of companies.)-induced gynaecomastia and/or breast pain.


METHODS
This open-label, non-comparative, multicentre study included 51 patients receiving bicalutamide 150 mg for the treatment of non-metastatic prostate cancer (T1b-T4, Nx, M0). Patients who developed symptomatic gynaecomastia and/or breast pain received two 6-Gy fractions of external-beam radiation to the breasts and were then assessed at two 3-monthly follow-up visits.


RESULTS
37/51 (72.5%) patients experienced gynaecomastia and 41/51 (80.4%) experienced breast pain, typically within the first 6 months. Twenty seven and 38 patients, respectively, went on to receive breast irradiation. Following radiotherapy, gynaecomastia improved or resolved in 7/27 (25.9%) and 2/27 (7.4%) cases, respectively, and breast pain improved or resolved in 12/38 (31.6%) and 3/38 (7.9%) cases, respectively. No change was observed in 7 patients (25.9%) with gynaecomastia and 12 patients (31.6%) with breast pain, while 9 patients (33.3%) and 8 patients (21.1%), respectively, worsened. Radiotherapy-related adverse events, reported by 18/41 (43.9%) patients, were generally mild and short lived (median duration approximately 5 weeks).


CONCLUSIONS
Therapeutic radiotherapy, using two fractions of 6 Gy external-beam radiation to the male breast, improves the intensity of bicalutamide-induced gynaecomastia and/or breast pain in approximately one-third of patients. Adverse events were often mild and short lived.
Van Poppel
H
H
Department of Urology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. Hendrik.VanPoppel@uz.kuleuven.ac.be
Tyrrell
C J
CJ
Haustermans
K
K
Cangh
P Van
PV
Keuppens
F
F
Colombeau
P
P
Morris
T
T
Garside
L
L
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000813:Anilides / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001940:Breast / Q000528:radiation effects*; D005500:Follow-Up Studies; D006177:Gynecomastia / Q000139:chemically induced / Q000453:epidemiology / Q000532:radiotherapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009570:Nitriles; D010146:Pain / Q000139:chemically induced / Q000453:epidemiology / Q000532:radiotherapy*; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D014105:Tosyl Compounds; D016896:Treatment Outcome
D000813:Anilides; D000970:Antineoplastic Agents; D009570:Nitriles; D014105:Tosyl Compounds; C053541:bicalutamide