Flutamide Versus Orchidectomy in the Treatment of Metastatic Prostate Carcinoma

Boccon-Gibod, L; Fournier, Georges; Bottet, P.; Maréchal, Jean Marie; Guiter, J; Rischman, P.; Hubert, Jacques; Soret, Jean-Yves; Mangin, P.; Mallo, C.; Fraysse, C. Esctein

doi:10.1016/s0022-5347(01)62628-4

Cited by 27 publications

(31 citation statements)

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“…The increased serum testosterone concentration during AA treatment is known from earlier studies with shorter follow-up than ours, 29,30 and is probably caused by lack of inhibition of the LH production in the pituitary gland. Estradiol is synthesized from testosterone and increases as a secondary effect.…”

Section: Discussionsupporting

confidence: 48%

Definitive radiotherapy with adjuvant long-term antiandrogen treatment for locally advanced prostate cancer: health-related quality of life and hormonal changes

Berg

Dahl

Bruland

et al. 2009

Prostate Cancer Prostatic Dis

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We assessed self-reported health-related quality of life (HRQoL) and longitudinal changes in sex hormones among 86 prostate cancer (PCa) patients without distant metastases 5 years after radiotherapy (RT) combined with ongoing antiandrogen (AA) treatment. HRQoL outcomes were compared with scores from age-matched controls without a cancer diagnosis (NORM). Compared with NORM, patients scored statistically (Po0.05) and clinically (effect size X0.4) lower on sexual domains, and statistically (Po0.05) lower on physical function and vitality. Estimated free testosterone and measured serum estradiol had increased from baseline in most patients, but did not correlate with HRQoL outcomes 5 years after the start of treatment.

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Section: Discussionsupporting

confidence: 48%

Definitive radiotherapy with adjuvant long-term antiandrogen treatment for locally advanced prostate cancer: health-related quality of life and hormonal changes

Berg

Dahl

Bruland

et al. 2009

Prostate Cancer Prostatic Dis

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“…Of these seven studies, 10 -16 only one compared flutamide monotherapy and castration. 14 Although no definite conclusions can be drawn from this small study (104 patients), overall survival at 69 months was identical in the two treatment groups. The other six studies compared flutamide monotherapy with other methods of androgen deprivation (Table 1): maximal androgen blockade (MAB), 16 diethylstilboestrol (DES), 10 -13 and estramustine.…”

Section: Flutamidementioning

confidence: 70%

“…There are no data on the comparative effects of flutamide monotherapy vs castration on sexual parameters, as the majority of the patients studied by Boccon-Gibod and colleagues 14 were impotent before study entry. Comparative data on other aspects of quality of life were not reported in any of the flutamide monotherapy studies.…”

Section: Quality Of Lifementioning

confidence: 99%

Is there a role for antiandrogen monotherapy in patients with metastatic prostate cancer?

Kaisary

Iversen

et al. 2001

Prostate Cancer Prostatic Dis

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“…The efficacy of nilutamide and flutamide as monotherapy has only been investigated in small non-comparative studies. Only one study showed equal mean time to progression between monotherapy and orchidectomy; in a comparison of flutamide (250 mg three times daily) and orchidectomy involving 104 patients, at the 24-month follow-up, mean time to progression was similar in each group (320 vs 352 days, P = 0.49; Boccon-Gibod et al, 1994).…”

Section: Anti-androgensmentioning

confidence: 98%

“…A smaller, meta-analysis of selected trials showed a statistically significant benefit for CAB (Caubet et al, 1996). Some studies reported a high incidence of withdrawal because of the side-effects of flutamide (Boccardo et al, 1990;Tyrrell et al, 1991;Boccon-Gibod et al, 1992). This may have skewed the results in favour of castration alone, particularly in those trials which did not employ a placebo.…”

Section: Combined Androgen Blockade (Cab)mentioning

confidence: 99%

Controversies in the management of advanced prostate cancer

1998

Br J Cancer

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For advanced prostate cancer, the main hormone treatment against which other treatments are assessed is surgical castration. It is simple, safe and effective, however it is not acceptable to all patients. Medical castration by means of luteinizing hormone-releasing hormone (LH-RH) analogues such as goserelin acetate provides an alternative to surgical castration. Diethylstilboestrol, previously the only non-surgical alternative to orchidectomy, is no longer routinely used. Castration reduces serum testosterone by around 90%, but does not affect androgen biosynthesis in the adrenal glands. Addition of an anti-androgen to medical or surgical castration blocks the effect of remaining testosterone on prostate cells and is termed combined androgen blockade (CAB). CAB has now been compared with castration alone (medical and surgical) in numerous clinical trials. Some trials show advantage of CAB over castration, whereas others report no significant difference. The author favours the view that CAB has an advantage over castration. No study has reported that CAB is less effective than castration. Of the anti-androgens which are available for use in CAB, bicalutamide may be associated with a lower incidence of side-effects compared with the other non-steroidal anti-androgens and, in common with nilutamide, has the advantage of once-daily dosing. Only one study has compared anti-androgens within CAB: bicalutamide plus LH-RH analogue and flutamide plus LH-RH analogue. At 160-week follow-up, the groups were equivalent in terms of survival and time to progression. However, bicalutamide caused significantly less diarrhoea than flutamide. Withdrawal and intermittent therapy with anti-androgens extend the range of treatment options. © 1999 Cancer Research Campaign

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Flutamide Versus Orchidectomy in the Treatment of Metastatic Prostate Carcinoma

Cited by 27 publications

References 0 publications

Definitive radiotherapy with adjuvant long-term antiandrogen treatment for locally advanced prostate cancer: health-related quality of life and hormonal changes

Definitive radiotherapy with adjuvant long-term antiandrogen treatment for locally advanced prostate cancer: health-related quality of life and hormonal changes

Is there a role for antiandrogen monotherapy in patients with metastatic prostate cancer?

Controversies in the management of advanced prostate cancer

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