title: Clinical Significance of Neoadjuvant Combined Androgen Blockade for More Than Six Months in Patients with Localized Prostate Cancer Treated with Prostate Brachytherapy.
abstract: BACKGROUND
  The aim of this study is to clarify the clinical significance of neoadjuvant combined androgen blockade (CAB) for ≥ 6 months in patients with localized prostate cancer.
  
  
  METHODS
  A total of 431 patients with localized prostate cancer who underwent prostate brachytherapy (BT) with or without neoadjuvant CAB for ≥ 6 months with mean follow-up time of 64.6 months (range 24-108 months) were evaluated retrospectively. Of those 431, 232 patients received BT in combination with neoadjuvant CAB for ≥ 6 months. Biochemical recurrence-free rates (BRFRs) in 364 patients with at least 3 years of follow-up were evaluated by log-rank test.
  
  
  RESULTS
  BRFR in patients with low-, intermediate- and high-risk prostate cancer were 98.1, 94.2 and 89.1%, respectively. In patients with intermediate-risk prostate cancer only, neoadjuvant CAB was significantly associated with BRFR (p = 0.0468). Especially in patients with intermediate-risk prostate cancer with radiation dose received by 90% of the prostate (D90) < 180 Gy, neoadjuvant CAB exerted a favorable impact on BRFR (p = 0.0429). On multivariate analyses, neoadjuvant CAB and D90 were independent predictors of BRFR (p = 0.0061 and p < 0.0001, respectively).
  
  
  CONCLUSIONS
  Neoadjuvant CAB for ≥ 6 months has a favorable impact on BRFR in patients with intermediate-risk prostate cancer, particularly in patients with relatively low radiation doses of D90.
authors.affiliation: Department of Urology, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto-cho, Tokushima, Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Senzaki
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Fukumori
authors.forename: Hidehisa
authors.initials: H
authors.lastname: Mori
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Kusuhara
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Komori
authors.forename: Junichiro
authors.initials: J
authors.lastname: Kagawa
authors.forename: Tomoya
authors.initials: T
authors.lastname: Fukawa
authors.forename: Yasuyo
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Kunihisa
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Takahashi
authors.forename: Akiko
authors.initials: A
authors.lastname: Kubo
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawanaka
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Furutani
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ikushima
authors.forename: Hiro-omi
authors.initials: HO
authors.lastname: Kanayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000008:administration & dosage*; D001706:Biopsy; D001918:Brachytherapy / Q000379:methods*; D003952:Diagnostic Imaging / Q000379:methods; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D004307:Dose-Response Relationship, Radiation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists