Intermittent Androgen Deprivation with Goserelin and Flutamide for Prostate Cancer: a Pilot Study

Jeon, Seong Soo; Choi, Han Yong

Abstract

PURPOSE: The purpose of this study was to evaluate the feasibility of using intermittent androgen deprivation(IAD) in patients with prostate cancer.
MATERIALS AND METHODS
We reviewed the medical records of 29 patients treated with IAD for prostate cancer. Androgen deprivation with goserelin and flutamide was continued for at least 4 months after serum prostate specific antigen(PSA) became undetectable or a nadir level was reached. Medication was then discontinued until serum PSA reached a predetermined level. This cycle of treatment was repeated until there was evidence of androgen independence.
RESULTS
Twenty-one patients completed the on-treatment during cycle 1, with a median time to PSA nadir of 3 months. Nine patients completed cycle 1 with a median time of off-treatment of 11 months(38% of a treatment cycle). Eight patients continued the off-treatment during cycle 1 for 1+ to 8+ months. During cycle 2, 3 patients achieved a PSA nadir in a median time of 3.5 months. While off treatment, most patients reported reduction of symptoms associated with androgen suppression.
CONCLUSIONS
IAD is a feasible alternative for continuous androgen deprivation for treatment of prostate cancer. It also results in the reducion of toxicity, cost of treatment, and possibly a delay in tumor progression.