ESTROGEN IN SHORT TERM COMBINATION WITH LHRH AGONIST IN PROSTATE CANCER

Abstract

The aim of this randomized study was to compare the prevention of so called “flare up” phenomenon and clinical efficacy of LHRH agonist (LHRHA) monotherapy with LHRHA and estrogen (E). In Group A, E was pre-administrated for 14 days prior to LHRHA and followed by 7 days of LHRHA with E administration. In Group B, E was combined with LHRHA for one week. Group C was LHRHA monotherapy. Serum T concentration in B and C groups was increased and was significantly higher than that in Group A during 14 days after the start of LHRHA therapy. Clinical efficacy was assessed by prostate specific antigen (PSA), clinical responses according to Japan Urological Association Criteria, and subjective responses. There was a significant difference in PSA only for 14 days from the start of LHRHA between Group A and others. In two patients in Group B and C, sever flare up was suspected. The increased cardiac side effects were observed in Group A. We conclude that E should be preadministrated prior to LHRHA therapy when patients have poor prognostic factors and are devoid of cardiac problems.