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A 16-year clinical experience with intermittent androgen deprivation for prostate cancer: oncological results
World Journal of Urology, 03/02/09

Prapotnich D et al. - In a study to present oncological results with intermittent androgen deprivation (IAD) in a single center, it was shown that IAD is an acceptable treatment in different stages of prostate cancer (PC). Duration of cycle decreased progressively during therapy. Age, Gleason score, and prostate-specific antigen (PSA) are factors predicting mortality.

Methods

566 pts with PC were selected for a non-randomized study of IAD.
218 pts had biochemical recurrence (BCR) after local treatment for PC and 348 pts had micro- or macro-metastatic disease.
On-treatment period (ONTP) consisted of 3-monthly injections of gonadatropin-releasing hormone (GnRH) agonist combined with daily oral androgen receptor antagonist.
Off-treatment period (OFTP) was indicated when PSA was <4 ng/ml.
Criteria for resumption of hormonal therapy were PSA >20 ng/ml or clinical symptoms.
Cancer-specific survival curves were computed according to the Kaplan–Meier method.

Results

Median follow-up was 81 mos; median age was 74.7 yrs; median Gleason score at diagnosis was 7; median initial PSA was 17 ng/ml.
Cycle duration decreased progressively from 23 mos for the 1st cycle to 10 mos at 12th cycle.
Number of pts who became hormone resistant was 182 (32%).
Median cancer-specific survival probability is 12 yrs.
No previous treatment group showed a higher cancer-specific survival probability vs BCR group.
Multivariate analysis of cancer-specific survival demonstrates age, initial Gleason score, and initial PSA level as significant factors affecting mortality.

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