Quality of life of patients with newly diagnosed poor prognosis M1 prostate cancer undergoing orchiectomy without or with mitomycin C - Results from the EORTC phase-III Trial 30893

Objectives: To compare the quality of life (QL) of patients with poor progn osis M1 prostate cancer treated with orchiectomy alone (ORCH) or orchiectom y combined with adjuvant mitomycin C (MMC; 15 mg/m(2) i.v. q 6 weeks: ORCH + MMC; EORTC trial 30893). Methods: Patients with newly diagnosed M1 poor prognosis prostate cancer co mpleted a truncated version of the EORTC OLQ-C30 (V 1.0) at randomization ( baseline) and every 6-12 weeks thereafter until going off the protocol. Fiv e ad hoc questions assessing lower urinary tract symptoms were included in the QL questionnaire. Results: At least one OL form was completed by 177 of the 189 patients incl uded in the trial, with baseline questionnaires available for 113 patients (ORCH n = 52; ORCH + MMC n = 61). In both arms, pain and urinary dysfunctio n improved during treatment. Compared with patients from the ORCH arm, the use of adjuvant MMC was associated with a significant reduction in global h ealth status/QL and with impairment in 7 of 11 QL dimensions covered by the questionnaire. Some improvement in QL was observed after discontinuation o f MMC. A survival benefit was not observed in the ORCH + MMC arm. Conclusions: Intravenous MMC (15 mg/m(2) q 6 weeks) cannot be recommended a s adjuvant treatment in M1 poor prognosis prostate cancer due to its negati ve impact on QL and lack of efficacy. In general, QL assessments should be mandatory when adjuvant chemotherapy is evaluated in patients with metastat ic prostate cancer. Copyright (C) 2000 S. Karger AG. Basel.