Improvement Of Lower Urinary Tract Symptoms In Patients With Prostate Cancer Treated With Maximal Androgen Blockade

objective:To explore the role and significance Of Maximal Androgen Blocking (Maximal Androgen Blockade, MAB) in improving lower urinary tract symptoms (LUTS) in patients who complained with advanced prostate cancer (Prostate Cancer, PCa).To Investigate the time of reaching maximum improvement of lower urinary tract symptoms of advanced prostate cancer patients who were treated with MAB. In order to provide guidelines in determining their treatment programs. Analysis the variation of lower urinary tract symptoms among different ages, different degrees of PSA values, different pathological stage of prostate cancer patients treated with MAB. Study its applicative value for the clinical treatment program to provide guidance.Methods:Retrospective analysis the clinical data of195advanced PCa patients complicated lower urinary tract symptoms and treated with MAB in the XiangYa Third hospital, Changsha City, Hunan province from2002to2011.Select IPSS score, Maximum urinary flow rate (Qmax), prostate volume (PV) as indicators reflecting the lower urinary tract symptoms. Record them before the treatment of androgen deprivation therapy and each time the patients review in a period of one year. Analysis the variation of IPSS score, Maximum urinary flow rate (Qmax), prostate volume in the patients treated with MAB. At the same time, we divided patients into different groups according to age, PSA value, histological differentiation.compare observed androgen Blockade differences in the degree of the different age groups, to check if there are different degrees of lower urinary tract symptoms improved in different groups and the time it persists. We take SPSS17.0software as statistical tool. The same group in different period was treated with repeated measures ANOVA; different groups of age、different PSA value range different pathological stage was compared using paired samples T-test, P <0.05was judged to have significant differences.Results:(1) Overall, The advanced prostate cancer treated with MAB, the IPSS、Qmax were significantly improved every month(P <0.05); after3months,the IPSS score、Qmax change tends to flat, each referral to the measured value get no significant differences. Overall with advanced prostate cancer populations, the duration of significantly decreasing of PV is the six months after MAB started; then, change has no significant difference.(2)Aged50-60years old,60-70,70-80-year-old groups with advanced PCa in the first three months of the MAB, the value of IPSS and Qmax were significantly improved compared with last month of each value. Then, the trend seem flat, the improvement is not significantly different. But to the70-80year-old sick people, significantly improving consisted only two month.The duration of PV continuously significantly decreasing is six months after MAB treatment, then changes get smoothly with no significant difference.(3)To the populations of the different PSA level, IPSS score、Qmax can be significantly improved in the first three months of MAB, the duration that IPSS score、Qmax significantly improved is there month. The duration of PV continuously significantly decreasing is six months after MAB treatment. Then their changes get smoothly with no significant difference.(4)In the first four months of the MAB treatment, LUTS of person that suffering well-differentiated-prostate-cancer, has been significantly improved every month, then the change comes to gentle; to poorly-differentiated prostate cancer population, the duration of LUTS significantly improving is first two months. The duration of PV continuously significantly decreasing to well-differentiated-prostate cancer population is nine months after MAB treatment; but to poorly-differentiated-prostate cancer population, the duration is6months.Conclusion:(1) MAB can significantly change the lower urinary tract symptoms of advanced prostate cancer, mainly in the three months since MAB started.(2) The duration of lower urinary tract symptoms significantly improved is2-4month.(3) After the above observation period, the patients with LUTS still have indications for surgery, we recommended surgical intervention.