Treatment of androgen-independent prostate cancer with dexamethasone: a prospective study in stage D2 patients.
OBJECTIVE
In order to evaluate the efficacy of dexamethasone in the treatment of Japanese men with androgen-independent prostate cancer, a prospective study was conducted using prostate-specific antigen (PSA) as a primary end-point.


METHODS
Nineteen Japanese men with stage D2 androgen-independent prostate cancer were registered and treatment was started. After ruling out anti-androgen withdrawal syndrome, they were treated with dexamethasone (1.5 mg daily). Patients were monitored for PSA, symptoms, radiologic response, survival rate, time to disease progression, time to treatment failure and complications.


RESULTS
Prostate-specific antigen levels decreased in nine patients (50.0%); five (27.8%) showed a 50% or greater decrease and two (11.1%) showed an 80% or greater decrease. For the nine patients, the mean duration of PSA response was 7.3 months and the median duration was 2.1 months (range, 1.2-27.5+). Bone pain, which was noted in 13 patients at study entry, improved in seven patients (53.8%). Of nine patients who had serial radiographic examinations with bone scan, three (33%) showed partial response, two (22%) were stable and four (44%) showed disease progression. Treatment was well tolerated, except for one patient who suffered a severe pulmonary infection.


CONCLUSIONS
Dexamethasone decreased PSA levels and produced subjective symptomatic improvement in the patients with stage D2 androgen-independent prostate cancer.
Saika
T
T
Department of Urology, Okayama University Medical School, Japan. takasaika@aol.com
Kusaka
N
N
Tsushima
T
T
Yamato
T
T
Ohashi
T
T
Suyama
B
B
Arata
R
R
Nasu
Y
Y
Kumon
H
H
D000368:Aged; D000369:Aged, 80 and over; D000728:Androgens; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000401:mortality; D015996:Survival Rate; D016896:Treatment Outcome
D000728:Androgens; D018931:Antineoplastic Agents, Hormonal; D003907:Dexamethasone; D017430:Prostate-Specific Antigen