A-blockers for the management of lower urinary tract symptoms in patients with prostate cancer treated with external beam radiotherapy: a randomized controlled study

Background This is a prospective study aiming to assess the efficacy of alpha-blockers in treating radiotherapy-induced symptoms of the lower urinary tract and its possible prophylactic role on acute urinary retention (AUR) in patients undergoing radical external beam radiotherapy (EBRT) for localized prostate cancer (PCa). Methods Overall, 108 patients with localized PCa were recruited and randomly assigned in to two groups; 54 patients of Group 1 received tamsulosin 0.4 mg once daily with the initiation of EBRT and for 6 months and 54 patients of Group 2 served as the control group. All patients received radical EBRT and had post-void volume (Vres) assessment. The International Prostate Symptom Score (IPSS) questionnaire and evaluation of episodes of AUR were performed after the end of radiotherapy, at 3 and at 6 months. Results The incidence of AUR was significantly (p = 0.027) lower in group 1 compared to group 2. No independent predictive factors for AUR were identified in regression analysis. The IPSS changes in univariate and multivariate analysis at 3 months showed significant correlation with alpha-blockers only, while at 6 months showed significant correlation with Vres assessments (at 3 and 6 months) and with alpha-blockers. Side effects due to medication were mild and none of the patients discontinued the treatment. Conclusions The selective use of alpha-blocker appears to prevent AUR in EBRT-treated patients. Although the administration of alpha-blockers might relieve patient-reported symptoms, there are no established independent predictive factors to distinguish patients who may benefit.

Automated summary

This prospective study suggests that the selective use of alpha-blockers can prevent acute urinary retention in patients undergoing EBRT for localized prostate cancer, while also relieving patient-reported symptoms. However, there are currently no established independent predictive factors to distinguish which patients may benefit from alpha-blocker therapy.