title: Total androgen blockade with the use of orchiectomy and nilutamide (Anandron) or placebo as treatment of metastatic prostate cancer. Anandron International Study Group.
abstract: The efficacy of total androgen blockade using orchiectomy and nilutamide was compared with orchiectomy with placebo in a large double-blind clinical trial with 457 patients. The median interval to objective progression was 20.8 months for total androgen blockade and 14.7 months for orchiectomy alone (P = 0.0041). The median interval to death for all patients was 37.1 months versus 29.8 months (P = 0.041). Decrease in pain was seen at months 1, 3, and 6 in a significant percentage for the total androgen blockade group. A significant difference in prostate specific antigen levels was seen at months 3 and 6, with normalization of 75% and 28%, respectively, in both groups at both times. The tolerance of the nonsteroidal antiandrogen nilutamide showed visual disturbances as a side-effect, resulting in the withdrawal of five patients from treatment. Liver and lung disturbances were transient. Total androgen blockade is a more effective treatment for metastatic prostate cancer than orchiectomy alone in this study population.
authors.affiliation: Department of Urology, Academic Hospital, Maasstricht, The Netherlands.
authors.forename: R A
authors.initials: RA
authors.lastname: Janknegt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D048289:Imidazolidines; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate
chemical_list: D000726:Androgen Antagonists; D000970:Antineoplastic Agents; D007093:Imidazoles; D048289:Imidazolidines; C021277:nilutamide