Effect of flutamide and flutamide plus castration on prostate size in patients with previously untreated prostate cancer.
OBJECTIVE
Transrectal ultrasonography (TRUS) was used in previously untreated men with prostate cancer undergoing hormonal therapy to provide objective observations on the decrease in prostate size and to assess the usefulness of prostate size in estimating treatment response.


METHODS
In this retrospective study, 31 patients with previously untreated prostate cancer (Stage T1c to D2) who received hormonal therapy (flutamide, n = 18; flutamide plus castration, n = 13) were followed with serial estimations of prostate size by TRUS and by serum prostate-specific antigen (PSA).


RESULTS
In both treatment groups, the major decreases in prostate size were noted within the first 6 months of therapy, whereas further follow-up examinations failed to show statistically significant changes. Prostate size decreased by 48% in men treated with flutamide, whereas those treated with flutamide plus castration showed a statistically significant greater decrease, mean of 56% (P < or = 0.01). Six patients (33%) in the flutamide group and 5 (38%) men in the total androgen deprivation group ultimately failed therapy as indicated by a rising PSA level. Only 55% (n = 6) of the patients who progressed showed an increase in prostate size.


CONCLUSIONS
Total androgen deprivation in comparison to flutamide alone caused a larger reduction in prostate size. As a marker of hormonal failure, a rising PSA was more sensitive than an increase in prostate size.
Noldus
J
J
Department of Urology, Stanford University School of Medicine, California 94305-5118, USA.
Ferrari
M
M
Prestigiacomo
A
A
Stamey
T A
TA
D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005485:Flutamide / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D012044:Regression Analysis; D012189:Retrospective Studies
D018931:Antineoplastic Agents, Hormonal; D005485:Flutamide; D017430:Prostate-Specific Antigen