�UroToday.com - Dr. Arto Salonen and Finnish colleagues compared intermittent androgen privation (IAD) to continuous androgenic hormone deprivation (CAD) in 856 patients with locally advanced or metastatic prostate cancer (CaP) treated at 27 clinics in Finland. This report represents an meantime analysis of their data.
The patients were accrued between 1997 and 2003 and had a life expectancy of at least 12 months. A 24 week flow in of continuous LHRH agonist therapy preceded randomisation for those who had a PSA decrease to
Mean patient role age was 72 days and hateful PSA at entry was 383ng/ml. Patients had point T3 tumors (61%) and stage T4 tumors (29%). A come of 564 men completed the row period and 279 were randomized to IAD and 285 to CAD. PSA, alkaline phosphatase, proportion of T4 tumors, poorly differentiated tumors, metastatic disease, and skeletal hot spots among patients with M1 disease were significantly higher in the IAD group. Baseline testosterone was not important in the analysis.
A significant proportion of patients with the most fast-growing and advance CaP did not reply to androgenic hormone deprivation therapy. The investigators concluded that IAD appears feasible for patients with locally advanced, hormone sore CaP. A low limit of testosterone at baseline did non select for IAD or CAD. Patients with advanced CaP, with a high PSA, alkaline phosphatase and metastatic disease, with more than 5 skeletal hot spots, did not read adequate biochemical response to ADT. Thus, they ar not good candidates for IAD and other modalities should be considered.
Salonen AJ, Viitanen J, Lundstedt S, Ala-Opas M, Taari K, Tammela TL
J Urol. 2008 Jul 15. Epub ahead of print.
doi:10.1016/j.juro.2008.05.009
Reported by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS
UroToday - the only urology website with original content scripted by world urology winder opinion leadership actively intermeshed in clinical practice.
To access the in vogue urology word releases from UroToday, go to:
www.urotoday.com
Copyright � 2008 - UroToday
More information
