Copenhagen, Denmark
Onsite/Online

ESTRO 2022

Session Item

Brachytherapy: Urology (prostate, bladder, penile)
Poster (digital)
Brachytherapy
Prospective study of tadalafil treatment in patients treated with prostate brachytherapy in Japan.
Nozomi Hayakawa, Japan
PO-1818

Abstract

Prospective study of tadalafil treatment in patients treated with prostate brachytherapy in Japan.
Authors:

Nozomi Hayakawa1, Ryuichi Mizuno2, Yutaka Shiraishi3, Tomoaki Tanaka3, Kazuhiro Matsumoto2, Takeo Kosaka2, Toshio Ohashi3, Eiji Kikuchi4, Naoyuki Shigematsu5, Mototsugu Oya2

1St. Marianna University School of Medicine, Urology, Kanagawa, Japan; 2Keio University School of Medicine, Urology, Tokyo, Japan; 3Keio University School of Medicine, Radiology, Tokyo, Japan; 4St. Marianna University School of Japan, Urology, Kanagawa, Japan; 5Keio University School of Medicine, Radiology, Kanagawa, Japan

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Purpose or Objective

We assess prospectively the efficacy of tadalafil for urinary and sexual dysfunction after prostate brachytherapy (PB) compared with tamsulosin hydrochloride in the patients treated with PB for localized prostate cancer.

Material and Methods

Overall 111 patients treated with PB were randomized into two groups of either those treated with daily use of 0.2mg of tamsulosin hydrochloride (N=56, Tam group) or 5mg of tadalafil (N=55, Tad group) just after PB. Sexual and erectile function were assessed before PB (baseline), and 1, 3, 6, 12 months postoperatively using International Index of Erectile Function-15 (IIEF-15) and Erection Hardness Score (EHS). We also assessed urinary function using questionnaires of International Prostate Symptom Score (IPSS) and Over Active Bladder Symptom Score (OABSS).

Results

 Mean±SD of baseline IIEF-15 score, EHS, IPSS and OABSS were 26.0±20.4, 2.2±1.5, 7.9±6.1 and 3.3±2.7 in Tad group and 21.0±17.9, 1.9±1.6, 7.7±5.9 and 3.4±2.2 in Tam group respectively, with no significant difference. Mean±SD of IIEF-15 and EHS 1,3,6,12 months after PB were 17.0±14.1, 23.3±18,8, 23.6±18.9, 25.3±21.6 and 1.9±1.6, 2.3±1.4, 2.2±1.5, 2.3±1.4 in Tad group, and 14.7±10.9, 15.7±13.2, 17.2±12.6, 19.2±14.0 and 1.3±1.5, 1.4±1.4, 1.4±1.3, 1.6±1.3 in Tam group. IIEF-15 score were significantly decreased in both groups at a month. after PB compared with the baseline (Tam group: p=0.001 Tad group: p<0.001). It was improved to a level not significantly different from the baseline (baseline level) at 3 months in the Tad group and at 6 months in the Tam group. EHS was significantly decreased at the 1, 3, 6 months after PB compared with the baseline (p=0.013, p=0.039, p=0.002, respectively) and it was improved to baseline level at 12 months, in the Tam group. In contrast, it was not significant difference between baseline and 1, 3, 6, 12 months after PB in Tad group. Comparing of two groups, IIEF-15 score was significantly lower in Tam group than in Tad group at 3 months only (p=0.011). On the other hand, EHS was significantly lower in the Tam group than in Tad group at 1, 3, 6, 12 months (p=0.046, p=0.002, p=0.007, p=0.019, respectively). Mean±SD of IPSS and OABSS 1, 3, 6, 12 months after PB were 17.4±9.2, 17.0±8.8, 14.9±8.9 and 9.6±6.8 6.6±3.9, 7.1±3.6, 5.8±3.4, 4.1±2.6 in Tad group, and 16.1±8.5, 15.6±8.2, 13.0±7.2, 9.1±6.6 and 6.0±3.3, 6.0±3.1, 5.1±2.7, 3.7±2.4 in Tam group. They were significantly higher in both groups at the 1, 3, 6 months after PB compared with the baseline (Tad group: IPSS; all p<0.001, OABSS; all p<0.001, Tam group: IPSS; p=0.001, p<0.001, p<0.001, OABSS; all p<0.001, respectively). They were improved to baseline level only in Tam group at 12 months. There were no significant differences between two groups at the 1, 3, 6,12 months. 

Conclusion

Findings indicate a global decrease in sexual and urinary function status after PB even using tamsulosin hydrochloride and tadalafil. Erectile function might be preserved by tadalafil treatment.