[Final results of complete hormone blockade versus monotherapy in prostatic metastatic cancer. PSA implications].
Of 102 patients with metastatic prostate cancer, 52 were treated with orchidectomy and 50 with CHB; 22 of these received a LHRH analog + Flutamide and 28 orchidectomy + Flutamide. No differences were seen in either arm in terms of age (69.9 vs 70.2 years) or initial PSA (493.3 vs 486.5 ng/ml) variables. After three months treatment, CHB achieved a decrease of PSA higher than monotherapy (52.9 vs 34.5 ng/ml) p<0.01 as well as minimum PSA level during follow-up (41.2 vs 17.5 ng/ml) (p<0.001). Initial clinical response rates were higher in the group treated with complete blockade (42.3% vs 52%) (p=n.s.). Overall, no significant differences were seen between the actuarial curves of biological progression, clinical progression and survival, with expected mean values of 13 vs 12, 14 vs 15 and 34 vs 28 months, respectively. However, when survival was considered as a function of bone disease dissemination, a greater survival rate was seen in patients with minimal M1 disease (p<0.05), and there were no differences between the M2 and M3 arms.
Morote
J
J
Servicio de Urología y Medicina Nuclear, Hospital General Universitario Vall d'Hebrón, Barcelona.
Vallejo
C
C
Lorente
J A
JA
Encabo
G
G
López Pacios
M A
MA
de Torres
J A
JA
Soler Roselló
A
A
D000206:Actuarial Analysis; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D005485:Flutamide / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D009919:Orchiectomy; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate
D018931:Antineoplastic Agents, Hormonal; D007987:Gonadotropin-Releasing Hormone; D005485:Flutamide; D017430:Prostate-Specific Antigen
Resultados definitivos del bloqueo hormonal completo versus monoterapia en el cáncer de próstata metastásico. Implicaciones del PSA.