Combination of Chemotherapy and Hormones in Prostatic Cancer

Abstract

The National Prostatic Cancer Project in a four-year period has accessioned 301 patients with newly diagnosed Stage D-2 prostatic cancer into a treatment protocol comparing cyclophosphamide (Cytoxan) plus estramustine phosphate (Estracyt) versus Cytoxan plus diethylstilbestrol (DES) versus either DES or bilateral orchiectomy. The three treatment arms appear comparable in terms of entry criteria with the exception of elevated acid phosphatase for one arm which as yet has not influenced the response rates. Thus far, toxicities to the chemotherapy combination treatment arms have not been excessive although more prevalent than in the DES/orchi-ectomy arm. Major toxicities have been anemia, leukopenia and nausea and vomiting. Preliminary data show that the treatment arm consisting of DES plus Cytoxan is showing a slight but nonsignificant advantage in delaying progression of the disease compared to the other two treatment arms at the initial 12-week evaluation. Patient follow-up and data collection is still not complete for the assessment of survival and response durations. Approximately one-third of patients entered into the study are still on original or crossover therapy with 75% of patients still in that category. More complete and meaningful data should be available in another 18 months.