Adult urologyCombination of LHRH analog with somatostatin analog and dexamethasone versus chemotherapy in hormone-refractory prostate cancer: a randomized phase II study
Section snippets
Patient population
During a 2-year period, 40 patients were recruited for this randomized Phase II study. Patients were eligible if they had Eastern Cooperative Oncology Group performance status of 0 to 3, had adenocarcinoma of the prostate that was progressing despite androgen deprivation, with measurable or assessable metastases, and had not received prior chemotherapy, diethylstilbestrol, estramustine, dexamethasone, or a somatostatin analog. All antiandrogen therapy was discontinued for at least 1 month, and
Results
The patient and disease characteristics are shown in Table I and were well balanced between the two treatment groups.
The PSA response data are shown in Table II. Approximately one half of the patients in each group achieved at least a 50% reduction in their PSA level. The median time for a PSA response was 7 weeks in the chemotherapy group and 9 weeks in the combination therapy group. An improved or stable bone scan was noted in 59% and 44%, respectively, of patients with osseous disease in
Comment
In our patients with HRPC, chemotherapy with estramustine and etoposide was compared with the combination of the somatostatin analog lanreotide and dexamethasone in addition to androgen ablation by orchiectomy or the LHRH analog triptorelin. The two treatments resulted in similar responses in terms of PSA level, measurable disease, osseous disease, time to progression, and overall survival. The quality of life, expressed as the performance status and pain score, did not differ between the two
Acknowledgements
To the following physicians for contributing patients to the study: Charalambos Arvanitis, Athanasios Bekos, Michael Bourounis, Antonios Farmakis, Charalambos Fasoulakis, Paraskevas Kalomiris, Ioannis Kastriotis, Petros Kirtsis, Theoharis Lambou, Michael Likourinas, Konstantinos Papoulis, Iraklis Poulias, Zoucher Sami, and Athanasios Tsintavis.
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