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1.
Tumori ; 84(1): 39-44, 1998.
Article in English | MEDLINE | ID: mdl-9619712

ABSTRACT

In a prospective trial conducted by the Gruppo Onco Urologico Piemontese, newly diagnosed prostate cancer patients with bone metastases were randomized to receive goserelin (3.6 mg subcutaneously every 4 weeks) or goserelin plus mitomycin at 14 mg/m2 i.v. every 6 weeks. Treatment was planned to be continued until progression. The study was interrupted because of inadequate accrual rate when 63 patients had been recruited. A long-term follow-up (median, 47 months), performed to counterbalance the limited number of patients included, revealed no difference in time to progression and overall survival between the study treatments. However, 56.5% of assessable patients allocated to the chemotherapy arm presented a > or =90% reduction of prostate-specific antigen levels compared with 36.3% in the goserelin group, and previously elevated levels normalized in 73.9% versus 45.4%. Non-progressing patients received 5-7 cycles of mitomycin C with acceptable toxicity, but the cytotoxic treatment was interrupted early in all cases within the first year due to cumulative myelotoxicity. In conclusion, the results, although inconclusive, fail to support a clear advantage in terms of cost/benefit of chemotherapy plus hormone therapy over hormone treatment alone in advanced prostate cancer with bone involvement.


Subject(s)
Antibiotics, Antineoplastic/therapeutic use , Antineoplastic Agents, Hormonal/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Neoplasms/drug therapy , Goserelin/therapeutic use , Mitomycin/therapeutic use , Neoplasms, Hormone-Dependent/drug therapy , Prostatic Neoplasms/drug therapy , Aged , Bone Neoplasms/blood , Bone Neoplasms/secondary , Disease Progression , Disease-Free Survival , Humans , Male , Middle Aged , Neoplasms, Hormone-Dependent/blood , Prospective Studies , Prostate-Specific Antigen/blood , Prostatic Neoplasms/blood , Prostatic Neoplasms/pathology , Survival Analysis , Treatment Outcome
2.
Anticancer Res ; 17(6D): 4697-702, 1997.
Article in English | MEDLINE | ID: mdl-9494591

ABSTRACT

A transient rise in serum alkaline phosphatase (ALP) activity (ALP flare) after androgen deprivation in prostate cancer patients with bone metastases has been previously correlated with both response to therapy and poor prognosis. In the present study we analyzed data coming from an Italian multicenter phase III, trial aimed to compare the efficacy of treatment with goserelin alone with that of goserelin plus mitomycin C. Sixty-seven bone metastatic patients were enrolled: 32 were treated with goserelin and 35 with and goserelin plus mitomycin. 58 cases had ALP measured every month; and were considered for flare assessment. Remarkably elevated ALP and PSA levels at baseline were significantly correlated with poor prognosis. The addition of mitomycin to goserelin resulted in a greater percent reduction of PSA values with respect to goserelin alone but did not augment the time to progression and overall survival. The monthly profile of ALP serum levels was superimposable in patients assigned to hormone therapy or chemotherapy plus hormone therapy. Patients showing a flare in ALP activity (transient rise > 15% in ALP values with respect to baseline at the first month) were classified as responders to therapy or as having stable disease upon PSA evaluation and/or at bone pain assessment, but had a shorter time to progression (median 12 months) in comparison to those showing a different ALP pattern (median 23 months). The measurement of flare in ALP activity during androgen suppression with or without concomitant mitomycin administration, may permit the early identification of patients who are likely to progress rapidly, and hence be candidate for more aggressive treatments.


Subject(s)
Alkaline Phosphatase/blood , Bone Neoplasms/secondary , Goserelin/therapeutic use , Mitomycin/therapeutic use , Osteoblasts/pathology , Prostatic Neoplasms/drug therapy , Prostatic Neoplasms/pathology , Aged , Antibiotics, Antineoplastic/therapeutic use , Antineoplastic Agents, Hormonal/therapeutic use , Bone Neoplasms/blood , Bone Neoplasms/drug therapy , Bone Neoplasms/pathology , Clinical Enzyme Tests , Disease-Free Survival , Humans , Italy , Male , Predictive Value of Tests , Prognosis , Prostatic Neoplasms/blood , Prostatic Neoplasms/mortality , Survival Rate
4.
Minerva Urol Nefrol ; 42(2): 77-80, 1990.
Article in Italian | MEDLINE | ID: mdl-2392744

ABSTRACT

The paper discusses a particular use of flow cytometric analysis, namely the quantitative study of DNA in the cellular sediment obtained from micturitional urine in patients with vesical tumours. Forty cases of carcinoma of varying degrees and stages were studied and, despite the small number of cases, interesting results have emerged regarding the close correlation between the test and the different clinical, cytological and histopathological aspects of the disease, and relating to the relative simplicity of the method used.


Subject(s)
Carcinoma/urine , DNA, Neoplasm/urine , Flow Cytometry , Urinary Bladder Neoplasms/urine , Aneuploidy , Carcinoma/pathology , Humans , Neoplasm Staging , Predictive Value of Tests , Urinary Bladder Neoplasms/pathology , Urine/cytology
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