Comparative study of intermittent versus continuous androgen blockade in the treatment of prostate cancer / 中华泌尿外科杂志

ABSTRACT

Objective To compare the efficacy and side effects of intermittent androgen depriva-tion (IAD) versus continuous androgen deprivation (CAD) in prostate cancer. Methods Forty-four patients with prostate cancer were divided into 2 groups. Twenty-one cases (group IAD) received IAD therapy. Of them, TNM staging showed T2 in 7 cases, T3 in 9 cases, T4 in 5 cases. The patients were treated by maximum androgen blockage until the serum PSA decreased to less than 0.2 ng/ml and maintained for 2 months. The treatment was resumed when the serum PSA increased up to 10.0 ng/ml or the symptoms occurred progress. Twenty-three cases (group CAD) underwent CAD therapy. Of them, TNM staging showed T2 in 7 cases,T3 in 12 cases,T4 in 4 cases. The time to prostate cancer progression,quality of life and side effect rate were compared between the 2 groups. Results The median time to disease progression was (36±4) months in group IAD and (30±4) months in group CAD,respectively. There was no significant difference between the 2 groups (P=0.132). The mean cycle length was (15.9±2.3) months, among them time on treatment and time off treatment were(8.8±1.5) months and (7.3±0.8) months, respectively. The symptom scores related to treatment in the treatment period and intermission of IAD group were 55.9±16.8 and 47.9±19.7, respective-ly, there was significant difference between them(P=0.007). But the differences between the treat-ment period and intermission in bone pain,urinary and intestinal symptoms were not significant (P> 0.05). The urinary symptom scores after 5 months of continuing treatment in groug CAD was signifi-cantly higher than the basis reference value which was obtained in the sixth month of initial treatment(P=0. 023), but there was no significant changes in the scores of bone pain, intestinal symptoms and symptoms related to treatment(P>0.05). The incidences of hot flash and gynecomastia were 28.6% (6/21) and 19.0%(4/21) in group IAD, 60.9%(14/23) and 52.2%(12/23) in group CAD, respec-tively. There were significant differences between the 2 groups(P<0.05). Conclusions IAD thera-py can alleviate the side effects of androgen deprivation therapy and improve the life quality. The effica-cy of prolonging the time to androgen independence of IAD therapy is similar to CAD therapy.