title: Use of alpha-1 adrenoceptor antagonists in patients who underwent low-dose-rate brachytherapy for prostate cancer - a randomized controlled trial of silodosin versus naftopidil.
abstract: BACKGROUND
  To evaluate the effect of two different alpha-1 adrenoceptor antagonists on lower urinary tract symptoms in patients who underwent LDR-brachytherapy.
  
  
  METHODS
  A total of 141 patients who had been clinically diagnosed with localized prostate cancer and underwent LDR-brachytherapy were enrolled. Patients were randomized and allocated to two groups (silodosin 8 mg vs. naftopidil 75 mg). The primary endpoint was a change in the international prostate symptom score (IPSS) at 3 months after seed implantation. Secondary endpoints included the recovery rate of IPSS at 12 months after seed implantation, the change in IPSS and overactive bladder symptom score, uroflowmetric parameters, and frequency volume chart (FVC). To determine independent variables that can predict IPSS recovery, logistic regression analysis was carried out.
  
  
  RESULTS
  The mean change in the IPSS at 3 months after seed implantation in both groups was ⊿10.6 (naftopidil) and ⊿10.4 (silodosin), respectively. There was not a significant difference between the two groups (p=0.728). An increase in urinary frequency and a decrease in total urinated volume and mean voided volume were observed in FVC for 12 months after seed implantation. Multivariate analysis revealed that the urethral dose (UD30) was an independent predictive parameter of IPSS recovery. Patients with UD30 < 200Gy showed a higher recovery rate of IPSS at 12 months after seed implantation.
  
  
  CONCLUSIONS
  There was no significant difference of serial change in IPSS between silodosin and naftopidil during the first year after seed implantation. A lower dose on the urethra was an independent predictor of IPSS recovery at 12 months after seed implantation.
authors.affiliation: Departments of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan. sendo@naramed-u.ac.jp.
authors.forename: Nobumichi
authors.initials: N
authors.lastname: Tanaka
authors.affiliation: Departments of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan. torimoto@nmu-gw.naramed-u.ac.jp.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Torimoto
authors.affiliation: Radiation Oncology, Nara Medical University, Kashihara, Nara, 634-8522, Japan. iasakawa@naramed-u.ac.jp.
authors.forename: Isao
authors.initials: I
authors.lastname: Asakawa
authors.affiliation: Departments of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan. makitomiyake@yahoo.co.jp.
authors.forename: Makito
authors.initials: M
authors.lastname: Miyake
authors.affiliation: Departments of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan. sanai@naramed-u.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Anai
authors.affiliation: Department of Urology, Nara Hospital Kinki University Faculty of Medicine, Ikoma, Nara, 630-0293, Japan. hirayamn@nara.med.kindai.ac.jp.
authors.forename: Akihide
authors.initials: A
authors.lastname: Hirayama
authors.affiliation: Radiation Oncology, Nara Medical University, Kashihara, Nara, 634-8522, Japan. hasegawa@naramed-u.ac.jp.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Hasegawa
authors.affiliation: Departments of Urology and Pathology, Nara Medical University, Kashihara, Nara, 634-8522, Japan. nkonishi@naramed-u.ac.jp.
authors.forename: Noboru
authors.initials: N
authors.lastname: Konishi
authors.affiliation: Departments of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan. kiyokun@naramed-u.ac.jp.
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fujimoto
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D053201:Urinary Bladder, Overactive / Q000209:etiology / Q000517:prevention & control*
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D007211:Indoles; D009281:Naphthalenes; D010879:Piperazines; C095285:silodosin; C064357:naftopidil