title: A 16-year clinical experience with intermittent androgen deprivation for prostate cancer: oncological results.
abstract: OBJECTIVE
  To present oncological results with intermittent androgen deprivation (IAD) in a single center.
  
  
  METHODS
  Between 1992 and 2008, 566 patients with prostate cancer (PC) were selected for a non-randomized study of IAD. Two hundred and eighteen patients had biochemical recurrence (BCR) after local treatment for PC and 348 patients had micro- or macro-metastatic disease. On-treatment period (ONTP) consisted of three-monthly injections of gonadatropin-releasing hormone (GnRH) agonist combined with daily oral androgen receptor antagonist. Off-treatment period (OFTP) was indicated when prostate-specific antigen (PSA) was <4 ng/ml. Criteria for resumption of hormonal therapy were PSA >20 ng/ml or clinical symptoms. Cancer specific survival curves were computed according to the Kaplan-Meier method.
  
  
  RESULTS
  Median follow-up was 81 months (12-230). Median age was 74.7 years (52-92). Median Gleason score at diagnosis was 7 (3-9). Median initial PSA was 17 ng/ml (0.4-433). Cycle duration decreased progressively from 23 months for the 1st cycle to 10 months at 12th cycle. The number of patients who became hormone resistant was 182 (32%). Median cancer specific survival probability for the series is 12 (10.8-infinity) years. No previous treatment group showed a higher cancer specific survival probability (log rank test, CI 95%, P = 0.003) versus BCR group. Multivariate analysis of cancer specific survival demonstrates age, initial Gleason score and initial PSA level as significant factors affecting mortality (P < 0.05).
  
  
  CONCLUSIONS
  Intermittent androgen deprivation is an acceptable treatment in different stages of PC. Duration of cycle decreased progressively during therapy. Age, Gleason score and PSA are factors predicting mortality.
authors.affiliation: Department of Urology, Institut Mutualiste Montsouris, Université Paris Descartes, 75014 Paris cedex, France. dominique.prapotnich@imm.fr
authors.forename: Dominique
authors.initials: D
authors.lastname: Prapotnich
authors.forename: Xavier
authors.initials: X
authors.lastname: Cathelineau
authors.forename: François
authors.initials: F
authors.lastname: Rozet
authors.forename: Eric
authors.initials: E
authors.lastname: Barret
authors.forename: Annick
authors.initials: A
authors.lastname: Mombet
authors.forename: Nathalie
authors.initials: N
authors.lastname: Cathala
authors.forename: Rafael E
authors.initials: RE
authors.lastname: Sanchez-Salas
authors.forename: Guy
authors.initials: G
authors.lastname: Vallancien
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D059002:Androgen Receptor Antagonists; D000813:Anilides / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D017273:Goserelin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009570:Nitriles / Q000627:therapeutic use*; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D013997:Time Factors; D014105:Tosyl Compounds / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D059002:Androgen Receptor Antagonists; D000813:Anilides; D018931:Antineoplastic Agents, Hormonal; D009570:Nitriles; D014105:Tosyl Compounds; D017273:Goserelin; D007987:Gonadotropin-Releasing Hormone; C053541:bicalutamide