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Biochemical control of the combination of cyclooxygenase‐2 inhibitor and 125 I‐brachytherapy for prostate cancer: Post hoc analysis of an open‐label controlled randomized trial
Author(s) -
Nakai Yasushi,
Tanaka Nobumichi,
Asakawa Isao,
Anai Satoshi,
Miyake Makito,
Morizawa Yosuke,
Hori Shunta,
Owari Takuya,
Fujii Tomomi,
Ohbayashi Chiho,
Yamaki Kaori,
Hasegawa Masatoshi,
Fujimoto Kiyohide
Publication year - 2020
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.14294
Subject(s) - medicine , brachytherapy , prostate cancer , urology , hazard ratio , tamsulosin , biochemical recurrence , randomized controlled trial , prostate , clinical endpoint , prostate brachytherapy , confidence interval , survival rate , cancer , celecoxib , radiation therapy , hyperplasia , prostatectomy
Objectives To evaluate the use of cyclooxygenase‐2 inhibitors in patients receiving low‐dose‐rate brachytherapy for prostate cancer. Methods A total of 310 patients with prostate cancer (cT1c‐3aN0M0) who received low‐dose‐rate brachytherapy between May 2010 and July 2013 were enrolled and allocated to one of the two treatment groups (tamsulosin alone 0.2 mg/day for 6 months vs tamsulosin 0.2 mg/day for 6 months plus celecoxib 200 mg/day for 3 months). The primary end‐point was the chronological change in international prostate symptom score, and the number of patients was assessed for the primary end‐point. Biochemical recurrence‐free, cancer‐specific survival and overall survival rates 5 years after the last patient received low‐dose‐rate brachytherapy were retrospectively examined. Results The median follow‐up period after low‐dose‐rate brachytherapy was 72.0 months (range 3–99 months). A total of 12 (3.9%) patients experienced biochemical recurrence. The biochemical recurrence‐free rate in the celecoxib group (5‐year biochemical recurrence‐free rate 98.5%) was significantly better (log–rank test P = 0.023, 95% confidence interval 0.07–0.63, hazard ratio 0.20) than that in the tamsulosin group (5‐year biochemical recurrence‐free rate 93.4%). None of the patients died from prostate cancer. However, 14 (4.5%) patients died of other causes. No significant difference was observed in terms of overall survival between the celecoxib and tamsulosin groups. Conclusions The combination of cyclooxygenase‐2 inhibitor and low‐dose‐rate brachytherapy can contribute to a better biochemical control of prostate cancer.