Quantifying the change in endorectal magnetic resonance imaging-defined tumor volume during neoadjuvant androgen suppression therapy in patients with prostate cancer

Mona V. Sanghani, Delray Schultz, Clare M. Tempany, David Titelbaum, Andrew A. Renshaw, Marian Loffredo, Kerri Cote, Beth McMahon, Anthony V. D'Amico
2003 Urology  
Objectives. To quantify the changes seen in the endorectal magnetic resonance imaging (erMRI)-defined prostate volume, predominant tumor volume, and secondary tumor volume during neoadjuvant total androgen suppression (TAS). Methods. Between July 1997 and April 2001, 152 consecutive patients with clinical Stage T1b-T3cNXM0 prostate cancer were treated with 6 months of TAS and external beam radiotherapy. erMRI was conducted before and after 2 months of neoadjuvant TAS. The median values and
more » ... ntage of changes in the erMRI-measured prostate volume and primary and secondary tumor volumes during neoadjuvant TAS were calculated and compared, using the Wilcoxon matched-pairs signed-rank method, for the patients overall and stratified by pretreatment risk group. Results. All patients had a significant decline in their erMRI-defined median prostate volume (36.6 versus 25.7 cm 3 , P Ͻ0.0001) during 2 months of neoadjuvant TAS. The median primary tumor volume decreased significantly in the intermediate-risk (0.77 versus 0.52 cm 3 , P Ͻ0.0001) and high-risk (2.48 versus 0.83 cm 3 , P Ͻ0.0001) patients. The median secondary tumor volume approached a significant decline in only the high-risk patients (0.45 versus 0.31 cm 3 , P ϭ 0.15). Fourteen percent of patients had an increase in their primary tumor volume during neoadjuvant TAS. Conclusions. The erMRI-defined primary and secondary tumor volumes generally decreased in the study population during neoadjuvant TAS. However, 14% of patients had an increase in their primary tumor volume during androgen suppression therapy. The clinical significance of this awaits further study. UROLOGY 62: 487-491, 2003.
doi:10.1016/s0090-4295(03)00463-1 pmid:12946752 fatcat:7wf2khv7evcy3knskobdsigm3u