[Study of intermittent endocrine therapy in patients presenting with biologic recurrence after radical prostatectomy or radiotherapy].
BACKGROUND
Study of the efficacy of intermittent endocrine therapy after failure of local treatment.


METHODS
74 patients were treated for biochemical recurrence after radical prostatectomy (n = 30), radiotherapy (n = 28) or radical prostatectomy followed by radiotherapy (n = 16). Treatment (63 patients were treated by antiandrogens alone, 8 by LHRH analogue and 3 by complete androgen suppression) was continued for 6 months after obtaining undetectable PSA levels for patients after radical prostatectomy (and restarted when PSA > 4 ng/ml) or a PSA nadir < 4 ng/ml for the other patients (and restarted for PSA > 10 ng/ml).


RESULTS
The duration of periods without treatment represented 50% of the total treatment cycle. With a mean follow-up of 43.8 months, the overall 5-year biochemical progression-free survival rate was 54.6%. On multivariate analysis, factors predictive of biochemical progression were age less than 70 years (p = 0.05), Gleason score greater than or equal to 8 (p = 0.038) and the presence of lymph node metastases (p = 0.05).


CONCLUSIONS
Intermittent endocrine therapy is a treatment option for patients with recurrence after local treatment. Candidates for intermittent endocrine therapy must be over the age of 70, with localized adenocarcinoma and a Gleason score less than or equal to 7.
de la Taille
Alexandre
A
Service d'Urologie, CHU Cochin, Paris, France.
Zerbib
Marc
M
Conquy
Sophie
S
Amsellem-Ouazana
Delphine
D
Saighi
Djillali
D
Debré
Bernard
B
D000367:Age Factors; D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D018450:Disease Progression; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D009367:Neoplasm Staging; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D012189:Retrospective Studies; D013997:Time Factors
D000726:Androgen Antagonists; D007987:Gonadotropin-Releasing Hormone