Treatment of androgen-independent prostate cancer with dexamethasone: A prospective study in stage D2 patients

Purpose: In order to evaluate the efficacy of dexamethasone in the treatmen t of Japanese men with androgen-independent prostate cancer, a prospective study was conducted using prostate-specific antigen (PSA) as a primary end- point. Methods: Nineteen Japanese men with stage D2 androgen-independent prostate cancer were registered and treatment was started. After ruling out anti-and rogen withdrawal syndrome, they were treated with dexamethasone (1.5 mg dai ly). Patients were monitored for PSA, symptoms, radiologic response, surviv al rate, time to disease progression, time to treatment failure and complic ations. Results: Prostate-specific antigen levels decreased in nine patients (50.0% ); five (27.8%) showed a 50% or greater decrease and two (11.1%) showed an 80% or greater decrease. For the nine patients, the mean duration of PSA re sponse was 7.3 months and the median duration was 2.1 months (range, 1.2-27 .5+). Bone pain, which was noted in 13 patients at study entry, improved in seven patients (53.8%). Of nine patients who had serial radiographic exami nations with bone scan, three (33%) showed partial response, two (22%) were stable and four (44%) showed disease progression. Treatment was well toler ated, except for one patient who suffered a severe pulmonary infection. Conclusion: Dexamethasone decreased PSA levels and produced subjective symp tomatic improvement in the patients with stage D2 androgen-independent pros tate cancer.