THE ANTIANDROGEN WITHDRAWAL SYNDROME - FI RST CLINICAL-EXPERIENCE ANDREVIEW OF THE LITERATURE

Since the mid-forties, hormonal treatment of prostate cancer has been the standard therapy for non-curative disease. One option is the addit ion of antiandrogens to bilateral orchiectomy or application of Gonado tropin-Releasing-Hormone analogues as a ''maximal androgen blockade''. Recently, reports have been published demonstrating that the withdraw al of antiandrogens in patients with progressive disease following max imal androgen blockade led to a decline in prostate-specific antigen ( PSA) values and even improvement in bone scans and tumor-related sympt oms in a subgroup of patients. We evaluated the effect of such an anti androgen withdrawal in 12 patients and found a remarkable PSA decrease in 3 cases. The review of the literature and our data indicate that a ntiandrogen withdrawal in progressive disease following maximal androg en blockade is safe and without side effects, and should precede any f urther therapy.