Effect of Hormonal Therapy for Volume Reduction, Lower Urinary Tract Symptom Relief and Voiding Symptoms in Prostate Cancer: Leuprolide vs Goserelin

The complaints of lower urinary tract symptoms in cases with prostate carcinoma (Pca) are associated with coexisting benign prostate hyperplasia or aging bladder. The aim of this study was to investigate and compare the effect of goserelin acetate with leuprolide acetate on total prostate volume (TPV), post voiding residue (PVR), International Prostate Symptom Score (IPSS) and maximum flow rate (Qmax) reduction in cases of advanced Pca. The study initially enrolled 71 patients who presented at our clinic for hormonotherapy because of advanced prostate carcinoma between May 2015 and August 2016. A total of 51 patients were found suitable for the study and were divided into two groups as Group 1 who received goserelin acetate (10.8 mg /3 months) and Group 2 who received leuprolide acetate (22.5 mg /3 months). Age, Gleason score, T stage, pre and post treatment Prostate specific antigen (PSA) and testesterone level, TPV, IPSS, PVR, and Qmax values were recorded retrospectively. Changes in parameters were assessed every 3 months. Analysis was made on 51 patients in this study. No statistically significant difference was determined between the two groups in respect of the mean percentage decrease in PSA (98.7% and 98.4%, respectively; P = .9) and testosterone (92.9 % and 96.4 %, respectively; P = .15) from baseline to 6 months but TPV reduced by -20.2 % ± 4.8 and -15.6 % ± 1.04, the median total IPSS score decreased by -34.77 % ± 8.8 and -19.77 % ± 6.1, median Qmax increased by 45.34 % ± 10.16 and 23.21 % ± 6.93, and median PVR decreased by -31.54 % ± 8.4 and -19.23 % ± 5.5, respectively for the two groups (all parameters P < .05) In this study, the improvement observed in voiding parameters with the use of goserelin acetate was better than with leuprolide acetate. The superiority of the goserelin acetate group was determined in particular on the reduction of TPV, PVR and IPSS. Although the PSA follow-up time was short, no significant difference was determined between the groups in the early oncological outcomes.