Prostatic cancer: evolution of treatment at a comprehensive center (1970-1974).

As a follow-up report to studies in previous decades, the present study covers 190 patients admitted to Roswell Park Memorial Institute for prostatic carcinoma during 1970 to 1974. The records of an additional 30 cases whose prostatic carcinoma was found incidentally at autopsy are included in this study for comparisons. The mean age at diagnosis was significantly lower than in the previous decade, with a greater proportion of progressions to an advanced clinical stage prior to admission to Roswell Park Memorial Institute. The incidence of cardiovascular deaths was much lower than in 1960 to 1969. Survival for all clinical stages was longer than that observed in the previous period and correlated with clinical stage. Serum acid and alkaline phosphatase levels progressively increased with clinical stage. Chemotherapy, which was rarely employed in the previous decade, found increasing usage during 1970 to 1974. There is a general trend to earlier diagnosis of prostatic adenocarcinoma.

Chemotherapy of advanced prostatic carcinoma with cyclophosphamide or 5-fluorouracil: results of first national randomized study.

The National Prostatic Cancer Project has randomized this study for endocrine-resistant prostatic cancer patients for treatment with standard hormonal or other therapies compared to 5-fluorouracil and cyclophosphamide. Both agents were found at the probability level of 0.05 to have a significant advantage over standard treatment in terms of objective response, subjective improvement and minimal toxicity. Additional chemotherapy protocols are currently under way. This randomized trial is the first report of such a national study completed to date. We are much encouraged by this program and believe that additional agents now under consideration will provide additionally encouraging results.