Side-effects of post-treatment biopsies in prostate cancer patients treated with endocrine therapy alone or combined with radical radiotherapy in the Scandinavian Prostate Cancer Group-7 randomized trial

Abstract

Objective. Post-treatment prostate biopsy side-effects were evaluated in patients with locally advanced prostate cancer on endocrine therapy alone or combined with radiotherapy in the Scandinavian Prostate Cancer Group-7 randomized trial. Material and methods. One-hundred and twenty patients underwent transrectalultrasound-guided biopsy, and were requested to complete a questionnaire on side-effects occurring within 7 days' follow-up. Results. The questionnaire was returned by 109 patients (91%) (endocrine therapy only 52%, combined endocrine therapy and radiotherapy 48%). Previous therapy had no significant influence on pain, urinary flow, haematuria or haematospermia. Pain at biopsy was reported in 63% (mild, 57%; moderate, 5.6%; severe, one patient) and pain at follow-up in 31% (mild, 27%; moderate, four patients). Haematuria (mean duration 2.2 days) was reported in 41%, and reduced urinary flow in 20% (mild, 18%; severe: four patients; no patient had urinary retention). Haematospermia was scarce. No patient reported urinary tract infection. Rectal bleeding occurred in 18% in the endocrine and 35% in the combined therapy group (p = 0.047), with a mean duration of 1.6 and 2.2 days, respectively (p = 0.031). In logistic regression analysis, a trend towards increased rectal bleeding was found in patients on combined endocrine therapy and radiotherapy (odds ratio 2.4, p = 0.050). Conclusion. Patient-reported post-treatment prostate biopsy side-effects were mild and self-limiting.

Key Words::

• Endocrine therapy
• post-treatment biopsy
• prostate cancer
• radiotherapy
• side-effects

Acknowledgements

We are grateful to the participating centres for recruitment of study patients. Sweden: Eskilstuna Hospital, Kullbergska Hospital, Malmö University Hospital, Umeå University Hospital, örebro University Hospital. Norway: Akershus University Hospital, Levanger Hospital, StOlav's Hospital – Trondheim University Hospital, Stavanger University Hospital, Sørlandet Hospital, Kristiansand, Ringerike Hospital. Support from the Oncology Centre in Umeå, and the assistance of the Clinical Research Office secretary at StOlav's Hospital, Karin Tulluan, is greatly appreciated. We also thank Professor Stian Lyderen at the Unit for Applied Clinical Research, Norwegian University of Science and Technology, for statistical advice and the Norwegian Cancer Society and the Nordic Cancer union for financial support.

Declaration of interest: Anders Angelsen has received lecture fees of less than US $1000 from AstraZeneca and Sanofi-Aventis. Anders Widmark has received an honorarium for advisory board from Roche and Astellas. The other authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.