A. Dupont et al., COMBINATION THERAPY WITH FLUTAMIDE AND THE LHRH AGONIST [D-TRP(6), DES-GLY-NH(2)(10)]LHRH ETHYLAMIDE IN STAGE-C PROSTATIC-CARCINOMA, British Journal of Urology, 72(5), 1993, pp. 629-634
A series of 1 15 previously untreated patients displaying clinical sta
ge C prostatic carcinoma with no evidence of distant metastases receiv
ed combination therapy using the antiandrogen flutamide and the LH RH
agonist [D-Trp6, des-Gly-NH210]LHRH ethylamide; the average follow-up
was 3.9 years. Twenty-eight patients showed treatment failure with a p
robability of disease-free survival of 91.2% at 2 years. Twenty patien
ts died from prostate cancer and 10 from other causes, the survival pr
obability being 93.4% at 2 years. Local control was achieved rapidly i
n all patients. Urinary obstruction and hydronephrosis were corrected
in all cases. When compared with data obtained after single endocrine
therapy (orchiectomy or oestrogens) or radiotherapy, the treatment fai
lure rate at 2 years was more than 3.0-fold lower after combination th
erapy (8.8%) than monotherapy (28.4%). The death rate 2 years after th
e start of combination therapy was 6.6% and was on average 22.2% (3.6-
fold higher) in the studies using monotherapy (orchiectomy or oestroge
ns) or radiotherapy. The present data suggest that treatment of prosta
te cancer with combination therapy before clinical evidence of dissemi
nation of disease permits more efficient control of local disease and
a decreased rate of progression to metastatic disease.