The Effect of Androgen Deprivation on the Early Changes in Prostate Volume Following Transperineal Ultrasound Guided Interstitial Therapy for Localized Carcinoma of the Prostate

Reviewers: Li Liu, MD
Source: International Journal of Radiation Oncology, Biology, and Physics, Volume 44, No 5 (July):1107-1110, 1999.

Background

The rising incidence of and mortality from prostate cancer has generated great interest in improving the results of current methods of treatment. The use of total androgen deprivation for treatment of prostate cancer, including therapy of early localized disease, has become more popular over the last decade or two. Quantitative measurement of the change in volume of the prostate after neoaduvant androgen deprivation remains lacking.

Methods

69 patients undergoing prostate brachytherapy for clinical stage T1c-T2b adenocarcinoma of the prostate were treated with at least 3 months of androgen deprivation therapy. Prostate volume was measured using ultrasound and/or CT scans at diagnosis, before the implant, and 11 to 13 days following the implant.

Results

• The mean and median decrease in prostate volume as a result of hormonal therapy was 23% and 32%, respectively.
• The duration of hormonal therapy did not seem to affect the median decrease in volume.
• The larger the volume at diagnosis, the more significant was the reduction in volume achieved after hormonal therapy.
• The change in prostate volume post implant varied a great deal with a median reduction of 3%. However, 33% of patients had an increase in prostate volume, including 23% who had an increase in volume >20% and 16% who had an increase in volume of >30%.

Discussion

Neoadjuvant hormonal therapy resulted in a median reduction in prostate volume of 33%. This reduction may facilitate the use of brachytherapy implants in the patients who would otherwise not to be ideal candidates due to the large volume of the prostate gland at diagnosis.