INTERMITTENT ANDROGEN SUPPRESSION IN THE TREATMENT OF PROSTATE CANCER: AN UPDATE OF THE VANCOUVER EXPERIENCE
| Autor: | R. C. Studd, S. L. Goldenberg, Antonio Hurtado-Coll, C. Zappavigna |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
business.industry Patient choice Urology General Medicine medicine.disease Androgen suppression General Biochemistry Genetics and Molecular Biology chemistry.chemical_compound Prostate cancer Castration chemistry Tumor progression Localized disease Cohort medicine business Hormone |
| Zdroj: | Journal of Investigative Medicine. 55:S104 |
| ISSN: | 1081-5589 |
| DOI: | 10.1097/00042871-200701010-00174 |
| Popis: | Objective Intermittent androgen suppression (IAS) is a feasible treatment for advanced prostate cancer (CaP). We review the long-term follow-up of an IAS cohort. Methods 106 men with a median age of 65.7 years (48.8-86.9) were identified who had been commenced on IAS. At IAS commencement, 16 patients had metastatic disease (MD, lymph node positive or positive bone scan) and 90 had localized disease (LD). Luteinizing hormone-releasing hormone agonist monotherapy was given every 1 to 4 months. A treatment cycle is defined as the time between the initiation of medical castration to the time point of the start of the next treatment phase. Treatment was resumed when the serum PSA increased to an arbitrarily chosen value. Cycles were continued until tumor progression to androgen independence (AI) or treatment was changed to continuous androgen suppression due to patient choice. Results The median follow-up for patients presenting with MD and LD was 47 (12-129) and 43 months (9-126), respectively. The median cycle length and median time off therapy were 20 and 12 months and 25 and 16 months for MD and LD, respectively. The median pretreatment PSA and Gleason score (GS) for LD were 10.2 ng/mL (0.2-450) and 7 (3-9). For MD, the presenting PSA (> 20 vs 20; 20.7 and 12.2 months vs PSA .05. Five patients with AI have died; the mean time to death from development of AI was 1.7 years. Conclusion Longer-duration follow-up of a single cohort supports IAS as a viable treatment option for men with advanced CaP. The PSA at the start of IAS is predictive of cycle length and time spent off therapy for patients with nonmetastatic disease. |
| Databáze: | OpenAIRE |
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