Intermittent androgen deprivation for aggressive prostate cancer: 8 years of clinical experience / 中华男科学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the safety and medication cycles of intermittent androgen deprivation (IAD) in the treatment of aggressive prostate cancer.</p><p><b>METHODS</b>Based on prostate cancer clinical staging, we divided 178 patients with aggressive prostate cancer into groups A (T3-4N0M0), B (TXN1M0) and C (TXNXM1) to receive maximum androgen blockage for at least 6 months till the PSA level remained at < or = 0.2 microg/L for 3 months, followed by an off-period (without medication). The on-period was initiated when the PSA level was > 4 microg/L, and then stopped again when it was < or = 0.2 microg/L. We recorded and compared the patients' age, baseline PSA levels, Gleason scores, duration of on- and off-period, and time to tumor progression.</p><p><b>RESULTS</b>The baseline PSA levels of the 3 groups were (27.5 +/- 14.6), (43.4 +/- 21.8) and (62.8 +/- 44.6) microg/L, P < 0.01; the follow-ups averaged (38.4 +/- 9.6), (33.1 +/-14.0) and (28.3 +/- 14.3) months; and the times from medication initiation to tumor progression were (37.4 +/- 6.6), (27.4 +/- 10.2) and (16.6 +/- 4.4) months, respectively. Group A showed a longer off-period and more medication cycles than B and C (P < 0.01). Nineteen patients completed 5 cycles and 2 died of cardiovascular events in group A. PSA elevation and cancer progression occurred after 3 cycles at most in group C. Six died in group B, 1 of metastatic prostate cancer, and 36 died in group C, 21 of metastasis.</p><p><b>CONCLUSION</b>For local aggressive prostate cancer, IAD can effectively slow down tumor progression, reduce adverse events and improve patients' quality of life.</p>