title: Comparison of prophylactic naftopidil, tamsulosin, and silodosin for 125I brachytherapy-induced lower urinary tract symptoms in patients with prostate cancer: randomized controlled trial.
abstract: OBJECTIVE
  To compare the efficacy of three α(1A)/α(1D)-adrenoceptor (AR) antagonists--naftopidil, tamsulosin, and silodosin--that have differing affinities for the α(1)-AR subtypes in treating urinary morbidities in Japanese men with (125)I prostate implantation (PI) for prostate cancer.
  
  
  METHODS
  This single-institution prospective randomized controlled trial compared naftopidil, tamsulosin, and silodosin in patients undergoing PI. Patients were randomized and received either naftopidil, tamsulosin, or silodosin. Treatment began 1 day after PI and continued for 1 year. The primary efficacy variables were the changes in total International Prostate Symptom Score (IPSS) and postvoid residual urine (PVR). The secondary efficacy variables were changes in IPSS storage score and IPSS voiding score from baseline to set points during the study (1, 3, 6, and 12 months).
  
  
  RESULTS
  Two hundred twelve patients were evaluated in this study between June 2006 and February 2009: 71, 70, and 71 patients in the naftopidil, tamsulosin, and silodosin groups, respectively. With respect to the primary efficacy variables, the mean changes in the total IPSS at 1 month after PI in the naftopidil, tamsulosin, and silodosin groups were +10.3, +8.9, and +7.5, respectively. There were significantly greater decreases with silodosin than naftopidil at 1 month in the total IPSS. The mean changes in the PVR at 6 months were +14.6, +23.7, and +5.7 mL in the naftopidil, tamsulosin, and silodosin groups, respectively; silodosin showed a significant improvement in the PVR at 6 months vs. tamsulosin. With respect to the secondary efficacy variables, the mean changes in the IPSS voiding score at 1 month in the naftopidil, tamsulosin, and silodosin groups were +6.5, +5.6, and +4.5, respectively; silodosin showed a significant improvement in the IPSS voiding score at 1 month vs. naftopidil.
  
  
  CONCLUSIONS
  Silodosin has a greater impact on improving PI-induced lower urinary tract symptoms than the other two agents.
authors.affiliation: Department of Urology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan. sugan@pd5.sonet.ne.jp
authors.forename: Hideyasu
authors.initials: H
authors.lastname: Tsumura
authors.forename: Takefumi
authors.initials: T
authors.lastname: Satoh
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Ishiyama
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Tabata
authors.forename: Shouko
authors.initials: S
authors.lastname: Kotani
authors.forename: Satoru
authors.initials: S
authors.lastname: Minamida
authors.forename: Masaki
authors.initials: M
authors.lastname: Kimura
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Fujita
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Masashi
authors.initials: M
authors.lastname: Kitano
authors.forename: Kazushige
authors.initials: K
authors.lastname: Hayakawa
authors.forename: Shiro
authors.initials: S
authors.lastname: Baba
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000368:Aged; D000704:Analysis of Variance; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D007457:Iodine Radioisotopes / Q000009:adverse effects; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D009281:Naphthalenes / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000175:diagnosis; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011788:Quality of Life; D011879:Radiotherapy Dosage; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D007211:Indoles; D007457:Iodine Radioisotopes; D009281:Naphthalenes; D010879:Piperazines; D013449:Sulfonamides; C095285:silodosin; D000077409:Tamsulosin; C064357:naftopidil