Therapeutic Effect of Maximal Androgen Blockade in Metastatic Prostate Cancer

Jeong, Seong Jin; Kwak, Cheol; Lee, Sang Eun

Abstract

PURPOSE: We aimed to evaluate the therapeutic effect of maximal androgen blockade (MAB) compared with that of medical or surgical castration alone in the treatment of the metastatic prostate cancer.
MATERIALS AND METHODS
We reviewed the progressive status and the survival of the patients with stage D Prostate cancer who had received hormonal therapies at our institution. Classified by treatment arms, the patients were divided into two groups. Group I was composed of 82 patients who had undergone either bilateral orchiectomy or GnRH agonist (goserelin acetate) injection alone, and Group II, of 65 patients who had undergone MAB with antiandrogen (flutamide) in addition to bilateral orchiectomy or gosereline acetate injection. We investigated the overall survival, time to objective progression, progression-free survival, and side effects.
RESULTS
The 5 year survival rates of Group I and II were 31.2 % and 32.5%, respec tively and median survival after the treatment was 34.2 months and 38.0 months respectively, which showed no significant differences between the two groups (p=0.21). The time to objective progression was 22.0 months in Group I and 24.0 months in Group II (p=0.52). Furthermore, each of median progression-free survival was 23.0 months and 24.0 months, respectively (p=0.79). In the minimal disease group, MAB appeared to increase the overall survival rate by 9.7%, progression-free survival rate by 7.3% and the time to objective progression by 10 months, respectively compared with the monotherapy.
CONCLUSIONS
In the hormonal therapy for the patients with stage D prostate cancer, there were no significant differences in overall survival, median progression-free sur vival, and time to objective progression between monotherapy and MAB. This indicates that MAB does not have any advantages.