title: Oncological outcomes of hormonal therapy with a gonadotropin-releasing hormone agonist combined with a steroidal or non-steroidal antiandrogen in patients with prostate cancer.
abstract: OBJECTIVE
  To determine the treatment outcome of combined androgen blockade (CAB) therapy using the non-steroidal antiandrogen bicalutamide or the steroidal antiandrogen chlormadinone in patients with prostate cancer.
  
  
  METHODS
  In total, 124 patients with prostate cancer enrolled in the present study were randomized to receive CAB therapy using a gonadotropin-releasing hormone (GnRH) agonist, combined with bicalutamide or chlormadinone. The survival of patients was analyzed.
  
  
  RESULTS
  The 5-year cancer-specific survival for the bicalutamide- and chlormadinone-treated groups were 91.7% and 86.6%, respectively, with no significant difference (p=0.39). Five-year overall survival was significantly (p=0.029) better in the bicalutamide-treated group. Moreover, M1 patients in the chlormadinone group had significantly lower cancer-specific and overall survival compared to those in the bicalutamide-treated group. However, in the case of M0 patients, no significant difference in cancer-specific nor in overall survival was observed.
  
  
  CONCLUSIONS
  CAB therapy using chlormadinone led to a significantly poorer survival outcome versus the use of bicalutamide. However, because this survival trend was not observed in M0 cases, chlormadinone may still be an option for CAB therapy, depending on clinical stage and the severity of adverse effects, such as hot flashes.
authors.affiliation: Department of Nephro-urology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki 852-8501, Japan. tigawa@nagasaki-u.ac.jp.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Igawa
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Tsurusaki
authors.forename: Koichiro
authors.initials: K
authors.lastname: Nomata
authors.forename: Mikio
authors.initials: M
authors.lastname: Hayashi
authors.forename: Masataka
authors.initials: M
authors.lastname: Furukawa
authors.forename: Hideki
authors.initials: H
authors.lastname: Sakai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000008:administration & dosage; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage; D006801:Humans; D008297:Male; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D007987:Gonadotropin-Releasing Hormone
keywords: Prostate cancer; antiandrogen; combined androgen blockade