title: Intermittent androgen suppression in the treatment of metastatic prostate cancer.
abstract: BACKGROUND
  To assess the feasibility of intermittent androgen suppression in patients with metastatic prostate cancer and to quantify the improvement in the quality of life.
  
  
  METHODS
  Forty-three patients with M1 b prostate cancer were treated by intermittent hormonal deprivation using luteinizing hormone-releasing hormone (LHRH) analogue alone (n = 11), or associated with an antiandrogen (n = 32). The prospective nonrandomized study required an initial therapy period of 12 months with a stable biological response during 6 months (PSA, testosterone). Treatment was resumed when the serum PSA value recovered to 20 ng/ml, or when local failure or new bone metastasis occurred. The assessment of quality of life was carried out using the EORTC QLQ-C30.
  
  
  RESULTS
  The mean follow-up time was 43.7 months. After the initial 12 months of androgen suppression, one patient with a minimal disease was off-therapy with a follow-up of 18 months. For the 42 other patients, the mean off-therapy period was 6.7 months. In the second therapy period (9-12 months), 7 patients were hormono-independent and died with a mean survival time of 27 months; 35 patients were responders. The mean off-therapy length in the second cycle was short (3.8 months). After this time, androgen suppression therapy was reintroduced permanently, but 10 patients were hormono-independent. No difference was observed in the EORTC QLQ-C30 between therapy and off-therapy periods, only a rapid decrease in adverse events due to the hormonal deprivation was reported in all cases during the off-therapy period.
  
  
  CONCLUSIONS
  Intermittent androgen suppression in patients with M1 b prostate cancer could be associated with a significant period off-therapy in the first cycle (55.8%), and with a chance of second hormone response. But in the second cycle, the off-therapy period length was short and required a careful follow-up.
authors.affiliation: Clinique Urologique, CHU, Hôtel Dieu, Nantes, France. obouchot@chu-nantes.fr
authors.forename: O
authors.initials: O
authors.lastname: Bouchot
authors.forename: L
authors.initials: L
authors.lastname: Lenormand
authors.forename: G
authors.initials: G
authors.lastname: Karam
authors.forename: D
authors.initials: D
authors.lastname: Prunet
authors.forename: N
authors.initials: N
authors.lastname: Gaschignard
authors.forename: J M
authors.initials: JM
authors.lastname: Malinovsky
authors.forename: J M
authors.initials: JM
authors.lastname: Buzelin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D011788:Quality of Life
chemical_list: D000726:Androgen Antagonists