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Neoadjuvant flutamide monotherapy for locally confined prostate cancer
Author(s) -
YOSHIMURA KOJI,
SUMIYOSHI YOSHITERU,
HASHIMURA TAKAYUKI,
UEDA TOMOHIRO,
KAMIRYO YORIAKI,
YAMAMOTO AKIHIRO,
ARAI YOICHI
Publication year - 2003
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1046/j.0919-8172.2003.00601.x
Subject(s) - medicine , flutamide , prostate cancer , urology , prostatectomy , testosterone (patch) , prostate , sexual function , antiandrogen , cancer , prostate specific antigen , oncology , gynecology , androgen receptor
Background: We compared the clinical effects and impact on quality of life (QOL) of patients who received a 3‐month course of flutamide monotherapy before radical prostatectomy with those who received a 3‐month course of luteinizing hormone‐releasing hormone (LHRH) agonist monotherapy. Methods: Thirty‐seven patients with non‐metastatic prostate cancer were enrolled in this study (19, flutamide; 18, LHRH agonist). The rates of change of serum prostate‐specific antigen (PSA) and testosterone levels, downsizing of prostate volume, the rate of organ confined disease, adverse effects and perioperative scores measured using the European Organization for Research and Treatment of Cancer Prostate Cancer Quality of Life Questionnaire (EORTC‐P) and the Sapporo Medical University Sexual Function Questionnaire (SMUF) were analyzed. Results: At radical prostatectomy, pathological variables were not significantly different in the two groups. Serum testosterone level was significantly higher (mean 359.2 compared to 10.5, P < 0.001), complete response rate of PSA (13% compared to 57%, P = 0.028) and rate of downsizing of prostate volume (mean, −17.7% compared to −35.4%, P = 0.038) were significantly lower in the flutamide group than in the LHRH group. After neoadjuvant hormone therapy, the scores on the sexual problem domain of EORTC‐P ( P = 0.033) and sexual desire score of SMUF ( P = 0.021) were significantly higher in the flutamide group than in the LHRH group. At a median follow‐up of 34 months after prostatectomy, biochemical failure‐free survival rate in the flutamide group did not differ from that in the LHRH group. Conclusion: This study suggests that flutamide monotherapy can be an acceptable modality as an option for neoadjuvant hormone therapy.