Management of advanced prostate cancer.
Most cases of advanced carcinoma of the prostate are hormonosensitive. The use of combined androgen blockade (CAB) seems to improve survival and quality of life, but only when combined with chemical castration by luteinizing-hormone-releasing hormone analog and without the use of steroidal antiandrogens. After CAB, further hormonal treatments remain efficacious, such as antiandrogen withdrawal followed by estrogens, aromatase inhibitors, and hormone-refractory prostate cancer multiple cytotoxic agents. For painful bone lesions, external beam radiotherapy, biphosphonates, and strontium 89 or samarium 153 provide pain relief. The use of new methods for the evaluation of response and quality of life will allow the rapid identification of effective treatments and permit powered phase III trials.
Auclerc
G
G
SOMPS, Salpêtrière Hospital, Department of Medical Oncology, Paris, France.
Antoine
E C
EC
Cajfinger
F
F
Brunet-Pommeyrol
A
A
Agazia
C
C
Khayat
D
D
D000726:Androgen Antagonists / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary*; D001918:Brachytherapy; D003131:Combined Modality Therapy; D004967:Estrogens / Q000627:therapeutic use; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use; D008297:Male; D010146:Pain / Q000188:drug therapy; D010347:Patient Care Planning; D011471:Prostatic Neoplasms / Q000628:therapy*; D011788:Quality of Life; D011878:Radiotherapy; D013326:Strontium Radioisotopes / Q000627:therapeutic use
D000726:Androgen Antagonists; D004967:Estrogens; D013326:Strontium Radioisotopes; D016729:Leuprolide