Abstract:
:Combined androgen blockade (CAB) is becoming standard treatment for patients with newly diagnosed advanced prostate cancer. This statement is based on the outcome and long-term evaluation of patients treated in prospective randomised trials. Particularly, patients with 'good' prognostic signs at the time of diagnosis benefit most from this approach. Patients with metastatic prostate cancer treated with CAB can be stratified on the basis of clinical prognostic parameters such as performance status, the presence or absence of pain, the levels of alkaline phosphatase, and the levels of prostate-specific antigen (PSA) during the first months of CAB: for combined androgen deprivation, if they fall in the good prognostic category (+/- 30-35% of the patients); for surgical castration and palliative treatment or (experimental) cytotoxic therapy if they belong to the poor prognostic category (+/- 20% of the patients), and, for initial CAB during the first 3-6 months of therapy, followed by an evaluation of the regression of PSA under therapy. If PSA normalises (rapidly) during this period, patients could be considered as good prognostic candidates and continue CAB. If PSA does not decrease or normalise sufficiently, patients might be classified as belonging to the poor prognostic category and should be treated with palliative measures and/or experimental cytotoxic therapy after (surgical) castration.
journal_name
Eur Uroljournal_title
European urologyauthors
Debruyne FMdoi
10.1159/000473836subject
Has Abstractpub_date
1996-01-01 00:00:00pages
34-6eissn
0302-2838issn
1873-7560journal_volume
29 Suppl 2pub_type
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