GOSERELIN ACETATE WITH OR WITHOUT FLUTAMIDE IN THE TREATMENT OF PATIENTS WITH LOCALLY ADVANCED OR METASTATIC PROSTATE-CANCER

From March 1987 to December 1990, 373 patients with stage C and D pros tate cancer were randomized to receive either goserelin acetate alone or goserelin acetate plus flutamide. At a median follow-up time of 24 months, there was no significant difference in the response rate, prog ression-free and overall survival between the two treatment groups. In particular, median time to progression was 18 months in the goserelin arm and 24 months in the combined treatment arm (P = 0.09). However, median time to progression in stage D patients was 12 months in both t reatment groups. Median time to death was 32 and 34 months, respective ly. The combination regimen produced a more rapid normalisation of pro static acid phosphatase levels and a more prompt relief of bone pain. However, significantly more patients in the combination arm experience d treatment-related side-effects such as diarrhoea and increases in tr ansaminase levels. The concurrent use of goserelin acetate and flutami de does not seem to significantly improve the results that can be achi eved with goserelin acetate alone.