Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Buserelin (B) is a synthetic nonapeptide analogue of native LHRH. Upon continued administration it reliably lowers the serum testosterone level to less than 100 ng/dl. It has been used in a clinical trial for the treatment of patients with stage C, D1, and D2 prostate cancer. Analysis of efficacy of testosterone suppression and toxicity included all 207 buserelin-treated patients. A comparison with historical controls from two National Prostate Cancer Project (NPCP) studies considered only the 147 evaluable patients with distant metastases (stage D2). All patients received buserelin, 500 micrograms q 8 hours subcutaneously (s.c.) for the first 7 days and then elected to take 200 micrograms s.c. daily or 400 micrograms q 8 hours by the intranasal (i.n.) route. Seventy-three percent elected s.c. administration. Only 2% changed the route of administration. The serum testosterone (T) level increased during week 1 in both the s.c. (426 ng/dl) and the i.n. (521 ng/dl) group but reached castrate (less than 100 mg/dl) levels by 4 weeks in 90% of patients. Subsequently, the likelihood of having a T level greater than 100 was higher for those treated by the i.n. than the s.c. route. The mean T level 4 and 12 months after therapy for the s.c. treated patients was 29 and 28. These values were 61 and 53 for those taking i.n. buserelin. This difference may in part be due to poor compliance. Toxicity was minor. Twelve percent of 151 s.c. treated patients had at least one episode of reaction at the injection site. None required discontinuation of the agent. Seventy-two percent experienced hot flushes; this was the same for both the s.c. and i.n. groups. Only 2 of 207 patients had a severe exacerbation of symptoms (spinal cord compression) during the first week of therapy. The criteria for response to therapy were those of the NPCP. There was no significant difference in the percentage of patients achieving a response when comparing the B-treated D2 patients to the NPCP D2 patients treated with DES, 3 mg daily, or orchiectomy. More of the B-treated patients entered with pain, a poor performance status, and weight loss than the DES/orchiectomy group. Nonetheless, the progression-free survival did not differ among the treatments. In summary, buserelin reliably lowers the serum T level by week 4 in 95% of men. Treatment efficacy is equivalent to a historical group treated with either DES or orchiectomy.
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PMID:Efficacy of buserelin in advanced prostate cancer and comparison with historical controls. 313 44

The purpose of this study was to develop a quantitative bone scintigraphy (QBS) method in order to evaluate the evolution of bone metastases in patients treated for disseminated prostatic cancer. Data obtained by whole body scintigraphy after injection of 99mTc-methylene diphosphonate enabled us to define three indexes, GR, R1 and R2. They respectively represent the amount of activity retained in the bones, in the metastatic sites and in pathological sites related to the global activity of the skeleton. Repeated QBSs have been performed on 59 patients with prostatic carcinoma treated for bone metastasis with hormonal therapy. Results of QBS are well correlated to clinical findings, particularly pain evolution. In addition, the calculated indexes of QBS made it possible to distinguish three groups of patients according to regression, stabilization or evolution of their lesions under hormonal therapy. QBS seems to be a sensitive and useful test for the evaluation of the therapeutic efficiency on bone metastases from prostatic carcinoma.
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PMID:Quantitative bone scintigraphy: usefulness in the survey of patients treated for bone metastasis of prostatic cancer. 314 88

Ketoconazole in high doses causes castrate levels of testosterone within twenty-four to forty-eight hours; therefore it is extremely useful in the initial medical treatment of patients with metastatic prostate cancer who need a prompt therapeutic response. Review of 17 patients who presented with severe radicular pain or acute paraparesis/paraplegia showed that there was frequent delay in urologic consultation, pathologic confirmation, and initiation of efficacious therapy. In fact, 5 of 12 patients (42%) who received radiation therapy prior to effective hormonal therapy suffered significant morbidity and mortality. The case is made for the use of ketoconazole for initial empirical therapy for these patients.
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PMID:Ketoconazole in initial management and treatment of metastatic prostate cancer to spine. 317 17

Forty-four patients with metastatic cancer of the prostate that had failed conventional hormonal manipulation were treated with high-dose ketoconazole (600-1,200 mg/day). All patients had castrate serum concentrations of testosterone prior to therapy. All of the patients had been assessed by the criteria of the National Prostatic Cancer Project and been categorized as progressing. Over 50% of the patients were recategorized as having stable disease. The majority of the patients showed marked subjective improvement in pain on this therapy. Objective responses were noted but were not consistently seen. Side effects were common but tolerable. The median time of survival was 73.3 weeks. Ketoconazole may be a useful palliative adjunct in the treatment of hormone refractory prostatic cancer.
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PMID:Effects of high-dose ketoconazole in patients with androgen-independent prostatic cancer. 324 85

Patients with newly diagnosed prostatic cancer should be investigated with regard to the presence or absence of distant metastases by (1) Taking a history especially of weight loss and recent onset backache (2) Examining them, looking especially for hepatic enlargement or peripheral lymph nodes (3) Performance status (4) Hemoglobin, Bilirubin, Liver enzymes, Alkaline and Acid phosphatase (5) Chest Xray. (6) Bone scan with specific Xrays directed at hot spots. (7) Ultrasound scan of liver if liver function tests are abnormal. Ultrasound scan of lymph nodes and kidneys is optional. (8) Any other tests indicated in special circumstances. Follow-up, 3-monthly as a rule, should include (1) The presence of pain and analgesic requirements (2) Weight (3) Performance status (4) Hemoglobin, Alkaline phosphatase, Acid phosphatase (5) Chest Xray, three monthly if abnormal. Annually otherwise. (6) Bone scan with Xray of new hot spots, 6-monthly. If there is doubt about the presence of a new hot spot, repeat the bone scan and Xray at 3 months.
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PMID:The staging of M1 disease: the role of bone scan, Xray and other imaging techniques. 329 62

Gallium nitrate, an agent known to inhibit bone resorption, was evaluated in patients with bidimensionally measurable hormone-refractory prostatic cancer. The starting dose was 200 mg/m2 iv by continuous infusion over 7 days. Two patients (10%; 95% confidence limits, 0%-22%) achieved short partial remissions of 1 and 6+ months, while seven of 23 (30%; 95% confidence limits, 14%-52%) showed a diminution of bone pain. Serial indices of bone turnover including serum calcium, phosphorus, and urinary hydroxyproline excretion showed a significant decrease at the completion of the infusion which returned to baseline prior to the next cycle. The data suggest the effect on bone was too short to produce consistent improvement. Reasons for the dissociation of pain relief and antitumor activity are discussed.
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PMID:Gallium nitrate in prostatic cancer: evaluation of antitumor activity and effects on bone turnover. 330 78

Although chronic treatment with luteinizing hormone-releasing hormone agonists achieves castration levels without side effects other than those related to hypoandrogenism, a limitation to their use alone for the treatment of prostatic cancer is the transient increase in serum androgens that lasts for 5 to 8 days at the start of treatment with the risk of disease flare. Our data show that the concomitant administration of the pure antiandrogen flutamide in association with the luteinizing hormone-releasing hormone agonist (D-Trp6) luteinizing hormone-releasing hormone ethylamide caused a 64 to 78 per cent decrease in serum prostatic acid phosphatase on days 3 and 7 after the start of treatment in 70 patients with previously untreated stage D2 prostatic cancer. Pain, which was present in 41 patients at the start of treatment, did not increase in any patient, it decreased in 7 at 1 week and it disappeared or decreased in 27 at 2 weeks. Performance, which originally was abnormal in 34 patients, became normal in 7 within 1 week and in 20 within 1 month (59 per cent). These data show that the addition of flutamide completely eliminates the risks of disease flare associated with the use of the otherwise exceptionally well tolerated luteinizing hormone-releasing hormone agonists in patients treated for prostatic cancer.
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PMID:Flutamide eliminates the risk of disease flare in prostatic cancer patients treated with a luteinizing hormone-releasing hormone agonist. 330 63

Twenty-two patients who had progressive metastatic prostatic carcinoma (Stage D2) despite androgen-deprivation therapy (bilateral orchiectomy, 10 cases; bilateral orchiectomy followed by diethylstilbestrol, 7 cases; diethylstilbestrol, 3 cases; combined megestrol acetate and low-dose estrogen, 2 cases) were treated with ketoconazole. Of 19 evaluable patients, 2 (11%) achieved a partial response (for 6 and 8 months) and 7 others (37%) achieved stabilization of disease (for periods of 3-8 months). Of 16 patients in whom pain was a prominent clinical feature, 13 (81%) noted improvement in pain for periods of one to eight months (median 3 months). We conclude that ketoconazole is a useful addition to our current armory for management of patients with metastatic prostatic cancer resistant to prior hormonal therapy.
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PMID:Ketoconazole therapy for hormonally refractive metastatic prostate cancer. 334 Oct 98

Five hundred and sixty-five patients with prostatic cancer, who first visited 9 institutions in Japan between 1981 and 1985, were analyzed. The peak of age distribution was in the seventies. As clinical symptoms, disturbance on micturition was the most frequent and pain caused by metastasis was a complaint in approximately one tenth of the cases. Alkaline phosphatase measurement, prostatic biopsy, intravenous pyelography, bone scintigraphy, cystourethrography, and measurements of serum prostatic acid phosphatase and serum acid phosphatase were performed on more than 80% of the patients. The clinical stage was stage A1 in 6.2%, A2 in 3.7%, B in 14.9%, C in 20.7%, D1 in 7.4%, and D2 in 43.7%. According to the histological grade, well, moderately and poorly differentiated adenocarcinoma were observed in 20.4, 33.3 and 32.7%, respectively. Increased ratio of high grade to low grade was noticed in the lower age group as well as in the advanced stage. In this series, endocrine therapy was still accepted in most of the patients. Almost all were treated with hormonal medication and half of them had undergone bilateral orchiectomy. Surgery, radiation, chemotherapy or multidisciplinary therapy were attempted judging from the clinical stage and histological grade. However, old age restricted the therapeutic modality. Actuarial survival rate at 5 years for stage A1, A2, B, C, D1 and D2 was 89.2, 66.1, 72.7, 51.0, 47.5 and 28.0%, respectively. In the patients with stage D2, the 5-year actuarial rate of poorly differentiated adenocarcinoma was lower than that of well or moderately differentiated adenocarcinoma, even though more intensive therapy was given to the former.
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PMID:[Trends in patterns of care for prostatic cancer in Japan: statistics of 9 institutions for 5 years]. 337 93

Eight-MHz radiofrequency hyperthermia (H) using Thermotron-RF8, and its combination with irradiation (RH), anticancer drugs (CH) or anticancer drugs plus irradiation (CRH), were carried out for a total of 93 urological malignancies: 19 cases of renal cancer, 3 of renal pelvic cancer, 4 of ureteral cancer 39 of bladder cancer, 8 of prostatic cancer, 14 of metastatic lesion of urological cancers and 6 of other urological cancers. All had failed in previous treatments, or had not undergone surgery because of their poor general condition. Nine cases, including 1 of renal cancer, 1 of ureteral cancer, 4 of bladder cancer, 2 of prostatic cancer and 1 of metastatic lesion of bladder cancer, were treated with (H). Fifty cases, including 4 renal cancer cases, 20 bladder cancer cases and 6 prostatic cancer cases, were treated with (RH). Eight of the 19 cases of renal cancer were treated with mitomycin C-microcapsule (MMC-mc) embolization prior to radiohyperthermia (CRH). The remaining 6 cases of renal cancer received embolization with MMC-mc followed by RE-heating (CH). Eighteen of the 48 cases of urothelial cancer or its metastasis, including 1 of renal pelvic cancer, 15 of bladder a cancer and 2 of metastatic lesion of bladder, received a combined treatment of intravenous THP-adriamycin, one of the derivatives of adriamycin and RE-heating (CH). In the remaining 2 cases, one received (CH), and the other received (CRH). Hyperthermia was given twice a week for a total of 10 sessions in 5 weeks. Intratumoral temperature was kept above 42.5 degrees C for 30 to 40 minutes during a one-hour heating. Complete tumor regression was obtained in 9 bladder cancer cases. Partial tumor regression, defined as a regression of 50% or more, was obtained in 17 cases. A pain relief was attained in 18 of 23 patients with intractable pain due to local tumor infiltration. As side effects, mild skin burns were observed in 21 cases. Ten obese cases, having subcutaneous tissue 15mm thick or more, developed fat tissue induration after treatment.
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PMID:[Eight-MHZ RF hyperthermia in urological malignancies]. 338 6


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