Administration of estramustine in response to changes in the prostate-specific antigen and Karnofsky index in the treatment of prostate cancer.
Androgen ablation is palliative and does not cure advanced prostate cancer. The hormone-sensitive cells die and the hormone-resistant cells overgrow, resulting in disease progression. The drug of choice for secondary treatment is estramustine (Estracyt). The success of the therapy is followed by changes of the prostate-specific antigen level and Karnofsky scale. In the present study, the results of estramustine treatment of 79 patients with advanced prostate cancer in 12 hospitals were evaluated. The mean prostate-specific antigen level improved for 6 months, but rose from the ninth month on. The improvement in the subjective condition of the patients paralleled the change in the prostate-specific antigen level. The short time of improvement was a consequence of the very high prostate-specific antigen level and the poor general condition. Estramustine administration is recommended when the prostate-specific antigen level becomes more than doubled following primary treatment. At a starting prostate-specific antigen level of > 100 ng/ml, the treatment leads to total androgen blockade. If the prostate-specific antigen level has not decreased after treatment for 3 months, the secondary strategy is to apply chemotherapy.
Pintér
Olivér
O
Department of UrologyMedical Faculty, University of Szeged, Hungary. pinter@comser.szote.u-szeged.hu
Molnár
Joseph
J
Tóth
Csaba
C
Szabó
Zoltán
Z
Lipták
Joseph
J
Fél
Pál
P
Papp
György
G
Hollman
Endre
E
Hazay
Lajos
L
Streit
Béla
B
Kisbenedek
László
L
Fehér
Miklós
M
Kocsis
István
I
Pajor
László
L
D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D004961:Estramustine / Q000627:therapeutic use*; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D012189:Retrospective Studies; D015996:Survival Rate
D018906:Antineoplastic Agents, Alkylating; D004961:Estramustine; D017430:Prostate-Specific Antigen