A 10-year clinical experience with intermittent hormonal therapy for XXXX .

@entity1 @entity263 @entity5 @entity158
OBJECTIVES: To evaluate, over a 10-year period, the feasibility, efficacy, duration of action and adverse effects of intermittent hormonal therapy (IHT) in @entity1 with advanced @entity263 or biochemical recurrence after radical treatment. MATERIALS AND METHODS: Two hundred and thirty-three @entity1 with @entity263 have been included in an IHT protocol since 1992. Fifty-five @entity1 had already been treated by radical prostatectomy (group A), 35 @entity1 had received radiotherapy or a treatment with high-intensity focused ultrasound (HIFU) (group B) and 143 @entity1 had not received any previous treatment (group C). Three-monthly injection of LHRH analogue combined with a non-steroidal antiandrogen was administered during the treatment phase ("on" phase). Treatment was stopped ("off" phase) when the PSA level fell below 4 ng/ml, regardless of the duration of the "on" phase. Criteria for resumption of hormonal therapy were PSA >20 ng/ml, PSA progression slope over the previous three months >5 ng/ml per month or recurrence of @entity158 or urinary symptoms. RESULTS: The median follow-up was 34.9 months (range: 13-151) and the median initial PSA was 28 ng/ml (range: 1-433). Five cycles were performed in the @entity1 with the longest follow-up. The mean duration of cycles was gradually decreased from 19.6 months to 11.8 months. The "on/off" ratio was close to 30% regardless of the cycle or @entity1 group. Ten @entity1 (4%) died from their @entity5 during the study, with a median survival of 42.2 months. Six @entity1 (2.5%) developed @entity158 symptoms during IHT. CONCLUSIONS: IHT ensures medium-term (three years) control of the disease, using a treatment resumption criteria of PSA >20 ng/ml and was not associated with major complications.
