title: [Castration modalities in prostate cancer: Are they all equal?].
abstract: OBJECTIVE
  The aim of this literature review was to focus on the new highlights regarding oncologic and safety outcomes depending on the type of castration used.
  
  
  METHODS
  Literature search using various algorithms "prostate cancer", "castration", "agonist", "antagonist", "orchiectomy", "GnRH", "FSH", "androgen deprivation therapy" has been performed in April 2015, through the PubMed and Embase databases.
  
  
  RESULTS
  GnRH agonists and antagonists are both currently used in clinical practice. Nevertheless, differences regarding their pharmacologic properties have been highlighted in recent studies, specifically regarding the rapidity, sustainability and depth of the castration, but also the decrease in FSH level. Such differences may have oncological impact on the patient, regarding the disease biological control and the time to progression, and a tolerability impact, especially on the cardiovascular risks. The role of the depth and the sustainability of the castration in one hand, the FSH impact in the other hand, as well as a direct inhibition on extra-pituitary GnRH receptors by antagonist might explain these differences.
  
  
  CONCLUSIONS
  Recent studies suggest differences between GnRH agonists and antagonist that could impact the patient clinical outcomes. However, further high level of evidence comparative studies remains warranted.
authors.affiliation: Clinique Saint-Jean-Languedoc, 20, route de Revel, 31400 Toulouse, France. Electronic address: g.ploussard@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Ploussard
authors.affiliation: CHRU Bretonneau, 37000 Tours, France.
authors.forename: F
authors.initials: F
authors.lastname: Bruyère
authors.affiliation: CHU Saint-Louis, 75010 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Culine
authors.affiliation: CHU Mondor, 94000 Créteil, France.
authors.forename: A
authors.initials: A
authors.lastname: de La Taille
authors.affiliation: CHU Saint-Louis, 75010 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Hennequin
authors.affiliation: Hôpital européen Georges-Pompidou, 75015 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Oudard
authors.affiliation: CHU de Rouen, 76000 Rouen, France.
authors.forename: C
authors.initials: C
authors.lastname: Pfister
authors.affiliation: CHU Bichat, 75877 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Ravery
authors.affiliation: CHU Mondor, 94000 Créteil, France.
authors.forename: L
authors.initials: L
authors.lastname: Salomon
mesh_terms: D000726:Androgen Antagonists / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D008297:Male; D009919:Orchiectomy / Q000379:methods; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D007987:Gonadotropin-Releasing Hormone
keywords: Agonistes; Androgen deprivation therapy; Antagonistes; Cancer de la prostate; Castration; FSH; GnRH; GnRH agonist; GnRH antagonist; Hormonothérapie; Orchidectomie; Orchiectomy; Prostate cancer