ABSTRACT
OBJECTIVE: The objective of this study was to assess the effect of dutasteride on serum prostate specific antigen (PSA) levels in men with serologic relapse following radical prostatectomy and/or radiation therapy for clinically localized adenocarcinoma of the prostate. METHODS: A prospective, single institution, IRB approved trial was conducted. Entry criteria required that all participants have serologic disease relapse only with serum PSA levels between 0.4 and 10.0 ng/ml. Enrolled participants were treated with 0.5 mg dutasteride daily. The primary endpoints were serum PSA level and clinical recurrence. The rate of durable decline in PSA was assessed according to the recommendations of the Prostate-Specific Antigen Working Group. RESULTS: Thirty-five patients provided informed consent and participated in the present study. At a median follow-up duration of 27 months (range, 4-42 months), 46% of enrolled men had a serum PSA decrease of greater than 10%, and 25% had a serum PSA decrease of greater than 50% (P < 0.001). Pre-study PSA doubling time (PSADT) (≥12 months vs. <12 months), and Gleason score (≤6 vs. ≥7) were associated with a better response to dutasteride, but only PSADT was statistically significant (P < 0.001). Thirty percent of patients experienced PSA progression (increase in serum PSA of greater than 50%). Two (6%) patients developed bone metastasis. No patient was removed from the study for drug-related toxicity. CONCLUSIONS: In the present pilot study, treatment with dutasteride resulted in a significant decrease in serum PSA in men with serologic relapse following radical treatment for adenocarcinoma of the prostate. These data appear to suggest that dutasteride may delay or prevent progression of prostate cancer in some men with biochemical relapse after radical therapy. These findings require confirmation in the setting of a larger, longer trial.
Subject(s)
5-alpha Reductase Inhibitors/therapeutic use , Adenocarcinoma/drug therapy , Azasteroids/therapeutic use , Neoplasm Recurrence, Local/drug therapy , Prostate-Specific Antigen/blood , Prostatic Neoplasms/drug therapy , Salvage Therapy , Adenocarcinoma/blood , Aged , Aged, 80 and over , Disease Progression , Dutasteride , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/blood , Pilot Projects , Prognosis , Prospective Studies , Prostatic Neoplasms/bloodABSTRACT
Three hundred thirty-nine college students were surveyed regarding their usual drinking behavior, alcohol expectancies, desired identity of power, and experience with alcohol-related violence. Eight percent indicated having been in a fight in a bar, and 16% indicated having been in a fight while drinking in the previous year. Male heavy drinkers were more likely than female heavy drinkers to experience alcohol-related and bar violence. The belief that intoxication causes one to become aggressive was related to experiencing alcohol-related violence. However, the relationship of alcohol expectancies to alcohol-related aggression was moderated by an individual difference in the desire to be seen as powerful. Results are discussed in terms of cognitive models of alcohol expectancy development and maintenance.
