Comparison between the Effects of Loxoprofen and Acetaminophen on Postoperative Pain Following Radical Prostatectomy: A Propensity Score Matching Analysis.

Non-steroidal anti-inflammatory medications are associated with renal impairment. However, there is little information on whether these medications affect postoperative renal function compared with acetaminophen. The objective of this study was to compare the effects of acetaminophen and loxoprofen, used as postoperative analgesic, effect on postoperative analgesia using propensity score matching analysis. We retrospectively enrolled 328 patients treated with loxoprofen or acetaminophen after open radical prostatectomy between October 2017 and February 2020. We analyzed postoperative pain intensity, the incidence rate of acute kidney injury, drug-induced liver injury, and rate of elevation in serum creatinine after open radical prostatectomy. Eighty-one matched pairs of patients treated with loxoprofen or acetaminophen were selected using propensity score matching analysis. The postoperative numerical rating scale was significantly higher in the acetaminophen group than in the loxoprofen group on postoperative day 5. The use of patient-controlled anesthesia and rescue analgesics was significantly higher in the acetaminophen group than in the loxoprofen group. The loxoprofen group had a significantly higher postoperative increase in serum creatinine than the acetaminophen group on postoperative days 5 and 8. The incidence of acute kidney injury was 4.9% in the loxoprofen group and 0% in the acetaminophen group, while the incidence of drug-induced liver injury was 0% in both groups. Acetaminophen appears to be safer than loxoprofen in terms of effects on renal function. Nevertheless, the number of acetaminophen doses and the dose per dose may need to be increased for patients with significant postoperative pain.

[CLINICAL STUDY OF SEQUENTIAL THERAPY WITH ABIRATERONE AND ENZALUTAMIDE FOLLOWING DOCETAXEL THERAPY FOR CASTRATION-RESISTANT PROSTATE CANCER].

(Purpose) This study is to evaluate the efficacy and safety of sequential therapy with two novel drugs, abiraterone and enzalutamide after docetaxel (DOC) therapy for castration-resistant prostate cancer (CRPC). (Material and methods) Twenty-one patients were identified received sequential therapy with abiraterone and enzalutamide after DOC therapy at our institution. We investigated PSA response (decrease of 50% or more) to prior administered drug as primary endpoint, and overall survival rate and occurrence of adverse events as secondary endpoint. (Results) There were 12 patients in the group preliminarily administered enzalutamide (Group E) and 9 patients in the group preliminarily administered abiraterone (Group A). The novel drugs were administered immediately following DOC therapy in nearly all cases. Of the 9 patients in Group A, only one patient (11%) and of the 12 patients in Group E, only one patient (9%) achieved PSA decrease of 50% or more, thus resulting in a poor response rate. There was not significantly difference in both groups. The overall survival rates of Group A and E were not significantly difference. There were three adverse events which required change drug. Those were two cases (appetite loss and general fatigue) on enzalutamide and one case (edema) on abiraterone. (Conclusion) This study suggested that sequential therapy with abiraterone and enzalutamide after DOC therapy had poor clinical benefit regardless of the order of administration of both drugs.

[Clinical study of long-term docetaxel based chemotherapy treatment for patients with castration-resistant prostate cancer].

PURPOSE: To evaluate long-term continuous administration of docetaxel (DOC), over survival rate, PSA level and adverse effects were analyzed, retrospectively. We also compared the results of long-term treatment group and short-term treatment group. MATERIAL AND METHODS: This study reported that 14 cases of long-term continuous administration of DOC consisting of 11 or more cycles among 51 patients of castration-resistant prostate cancer (CRPC) treated with DOC from October 2008 to September 2013 at our institution, retrospectively. Nineteen patients who had treated with DOC 10 or less cycles were defined as short-term dose group, and both groups were compared. DOC was administered every 3 to 4 weeks at 60 to 70 mg/m2, and was treated with prednisolone at 10 mg/day as a general. RESULTS: The median number of treatment cycles was 15. Thirteen cases showed a decrease in PSA levels and 10 cases showed a decrease in PSA levels of 50% or more, the 1-year survival rate of long-term dose and short-term dose group were 100% and 16%. Adverse effects of grade 3 or lower consisted of leukocytopenia in 85% and thrombocytopenia in 28%, however, grade 4 or higher were not observed in long-term dose group. In multivariable analysis of parameters, long-term treatment was related to PSA levels at start of treatment and ALP levels. CONCLUSION: Forty-two percent of patients who have CRPC at our institution undergo long-term DOC based chemotherapy treatment It may be suggested that long-term DOC based chemotherapy for some cases contribute to extend survival time with no serious adverse events.