A review of hormonal treatment in XXXX .

@entity1 @entity263 @entity5 @entity342 @entity3 @entity204
In the treatment of @entity263 , @entity342 ablation has proven to be the cornerstone. Several important questions about its use, however, remain unanswered. The first question is whether @entity342 ablation should be started at the time of diagnosis, or when symptoms arise. Although previous evidence had suggested no benefit to early therapy, a recent large trial of @entity1 has shown clear benefit. @entity1 with locally advanced and asymptomatic @entity3 were randomly assigned to early treatment, or treatment started at signs of progression: the early treatment group showed benefit in time to progression, incidence of severe complications, and time to @entity204 . The other major unresolved issue is the type of @entity342 ablation to be used. Maximal @entity342 blockade (MAB) has been shown to increase the survival of @entity1 with @entity3 in a least two large, well-conducted trial, although other trials have contradicted this finding. A recent meta-analysis of 22 MAB trials containing more than 5000 @entity1 has suggested that MAB does not prolong life. A large trial by the National @entity5 Institute (NCI) NCI INT-0105, from which preliminary results are now available, has shown that castration and an antiandrogen is no better than castration alone in terms of time to progression and survival. This trial, furthermore, did not find that MAB was superior in low-volume, good-performance status @entity1 . @entity342 ablation is not a cure for @entity263 , but it does provide excellent palliation. New treatment regimens, and new studies, are needed to optimize treatment for these @entity1 .
