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Neoadjuvant androgen deprivation for prostate volume reduction: The optimal duration in prostate cancer radiotherapy
Urologic Oncology: Seminars and Original Investigations, 07/24/09

Langenhuijsen JF et al. - In a study to determine the optimal duration of androgen deprivation for prostate volume reduction in a cohort of pts scheduled for external beam radiotherapy, it was revealed that the optimal duration of neoadjuvant androgen deprivation to reduce prostate volume before prostate cancer (PCa) radiotherapy is 6 mos. In small prostates, 3 mos of hormonal treatment may be enough for maximal volume reduction.

Methods

20 pts scheduled for external beam radiotherapy with cT2-3No/xMo PCa were treated with a luteinizing hormone releasing hormone agonist (busereline) and nonsteroidal anti-androgen (nilutamide) for 9 mos consecutively.
Repeated CT scan examination was performed 3-monthly to measure prostate volumes until the start of radiation therapy.
Analysis of volume reduction was performed with the Wilcoxon signed ranks test.

Results

Baseline median prostate volume for the cohort of pts was 82 cc with a median volume reduction of 31% after 3 mos of androgen deprivation.
Between 3 and 6 mos, median volume reduction of 9% was observed.
The effect was more pronounced in large prostates (>60 cc) than in small prostates (≤60 cc).
In all pts, no significant volume reduction occurred between 6 and 9 mos of maximal androgen blockade (MAB).

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