Benefits of intermittent/continuous androgen deprivation in patients with advanced prostate cancer
Abstract
Background and aims:
Huggins described in 1941 the effect of castration on prostate cancer. Gonadotropin-releasing hormone (GNRH) analogue were introduced in 1985. Complete androgen blocade (association of GNRH analogue with antiandrogen) was introduced by Fernand Labrie to achieve supression of suprarenalian testosterone. Long time androgen deprivation lead to androgen independence of prostate cancer cell.
Our principal aim was to demonstrate longer survival rates on prostate cancer patients with intermittent androgen deprivation.
Methods:
- 82 patients were enrolled at the Urology Deparment of West University „Vasile Goldiș” Arad in two groups with continous and intermittent androgen deprivation.
- Treatment efficiency was assesed by the level of testosterone and PSA.
- Adverse events (AE) and serious adverse events were reported according to Common Terminology Cryteria of Adverse Events (CTCAE) of the National Cancer Institute (NCI).
Results:
- Evolution towards castrate resistant prostate cancer: 12.5% from the intermittent androgen deprivation group and 23.8% from the continues androgen deprivation group
- Mortality rate: 15% of patients from the intermittent androgen deprivation group; 19% of patients from the continue androgen deprivation group
Conclusions:
1. Better quality of life (Qo)l in periods without treatment due to testosteron recovery; 2. Less AE’s and methabolic syndrom (MS) related complications; 3. Better survival and longer time of disease control and 4. Cost reduction