Intermittent XXXX suppression in the treatment of @entity263 : a preliminary report.

@entity1 @entity251 @entity137 @entity263 @entity73134 @entity5 @entity342
OBJECTIVES: To test the feasibility of using intermittent @entity342 suppression in the treatment of @entity263 by taking advantage of the reversible action of medical castration. METHODS: Observations were made on a group of 47 @entity1 (clinical @entity73134 ; and A2, 2) with a mean follow-up time of 125 weeks. Treatment was initiated with combined @entity342 blockade and continued for at least 6 months until a serum prostate-specific antigen (PSA) nadir was observed. Medication was then withheld until the serum PSA increased to a mean value between 10 and 20 ng/mL. This cycle of treatment and no treatment was repeated until the regulation of serum PSA became @entity342 independent. RESULTS: The first two treatment cycles lasted 73 and 75 weeks, with a mean time off therapy of 30 and 33 weeks and an overall mean percentage time off therapy of 41% and 45%, respectively. The mean time to achieve a nadir level of serum PSA was 20 weeks in cycle 1 and 18 weeks in cycle 2. Serum @entity251 returned to the normal range within 8 weeks (range, 1 to 26) of stopping treatment. The off-treatment period in both cycles was associated with an improvement in sense of well-being and the recovery of libido and potency in the @entity1 who reported normal or near-normal sexual function before the start of therapy. In 7 @entity1 with Stage D2 disease, the @entity5 progressed to an @entity342 -independent state. The mean and median times to progression were 128 weeks and 108 weeks, respectively. Seven @entity1 have died, 1 from a noncancer-related illness, with mean and median overall survival times of 210 weeks and 166 weeks, respectively. CONCLUSIONS: @entity263 is amenable to control by intermittent @entity342 suppression. This approach affords an improved quality of life when the @entity1 is off therapy. It also results in reduced @entity137 and cost of treatment and possibly delays @entity5 progression. Whether survival is affected in a beneficial or adverse way remains to be studied in a randomized, prospective study.
