title: Hot flashes during androgen deprivation therapy with luteinizing hormone-releasing hormone agonist combined with steroidal or nonsteroidal antiandrogen for prostate cancer.
abstract: OBJECTIVE
  To investigate hot flashes and quality of life during combined androgen blockade (CAB) therapy using steroidal or nonsteroidal antiandrogens.
  
  
  METHODS
  A total of 151 patients with prostate cancer, who were enrolled into this study from May 2001 to June 2003, were randomized to receive CAB therapy using a luteinizing hormone-releasing hormone agonist (leuprorelin) combined with a steroidal antiandrogen (chlormadinone) or a nonsteroidal antiandrogen (bicalutamide). The incidence of, frequency of, and distress due to hot flashes were evaluated with a self-administered questionnaire during a 2-year period. The general and disease-specific quality-of-life outcomes were also measured using the Functional Assessment of Cancer Therapy-Prostate questionnaire.
  
  
  RESULTS
  Data were available for analysis from 124 patients. Although the incidence of hot flashes largely tended to be greater in the bicalutamide group than in the chlormadinone group, no significant difference was noted in the cumulative incidence of hot flashes at 2 years. The median frequency of hot flashes daily was 1.3 and 2.2 for warmth/flushing (P = .16) and 1.0 and 3.6 for sweating (P = .021) in the chlormadinone and bicalutamide groups, respectively. Patients in the chlormadinone group were significantly less likely to be distressed by warmth/flushing (odds ratio 0.47, P < .001) and sweating (odds ratio 0.61, P = .01) than were those in the bicalutamide group. The Functional Assessment of Cancer Therapy-Prostate scores over time showed no intergroup differences.
  
  
  CONCLUSIONS
  Our results suggest that CAB using a steroidal antiandrogen such as chlormadinone might induce fewer and less-distressing hot flashes than CAB with bicalutamide.
authors.affiliation: Department of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. hsakai@nagasaki-u.ac.jp
authors.forename: Hideki
authors.initials: H
authors.lastname: Sakai
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Igawa
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Tsurusaki
authors.forename: Morishi
authors.initials: M
authors.lastname: Yura
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kusaba
authors.forename: Mikio
authors.initials: M
authors.lastname: Hayashi
authors.forename: Shotaro
authors.initials: S
authors.lastname: Iwasaki
authors.forename: Hironobu
authors.initials: H
authors.lastname: Hakariya
authors.forename: Tanetoshi
authors.initials: T
authors.lastname: Hara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kanetake
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D000813:Anilides / Q000008:administration & dosage / Q000009:adverse effects*; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects*; D002715:Chlormadinone Acetate / Q000008:administration & dosage / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives*; D019584:Hot Flashes / Q000209:etiology*; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D009570:Nitriles / Q000008:administration & dosage / Q000009:adverse effects*; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D011788:Quality of Life; D013256:Steroids / Q000008:administration & dosage / Q000009:adverse effects; D014105:Tosyl Compounds / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000726:Androgen Antagonists; D000813:Anilides; D018931:Antineoplastic Agents, Hormonal; D009570:Nitriles; D013256:Steroids; D014105:Tosyl Compounds; D002715:Chlormadinone Acetate; D007987:Gonadotropin-Releasing Hormone; C053541:bicalutamide; D016729:Leuprolide