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Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The National Prostatic Cancer Project (NPCP) from 1978 through 1985 compared definitive radiation therapy for Stages B2, C, D1 lesions in those who received only radiation treatment to those who received two years of additional cyclophosphamide (Cytoxan) or estramustine phosphate (Emcyt) chemotherapy. Two hundred fifty-four patients were entered and 229 evaluated for compliance of the spatial localization of the prostate through review of the simulation and port films. In 78 per cent this was satisfactory, whereas in 12 per cent it was unsatisfactory, and another 10 per cent were not evaluable. The principle cause of an unsatisfactory rating was failure to adequately cover the prostatic target volume, especially the apex which was found to be variable in location. Routine use of retrograde urethrocystography is urged as part of the localization method in patients to receive definitive external beam radiation therapy for prostate cancer. The role and impact of quality assurance programs for radiotherapy in cooperative clinical study groups is reviewed and discussed.
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PMID:Quality control of radiation therapy in multi-institutional randomized clinical trial for localized prostate cancer. 327 25

A prospective randomized trial for metastatic prostatic cancer in 220 patients who were refractory to hormone therapy was conducted by the National Prostatic Cancer Project from 1984 to 1985. As of July, 1986, the evaluation of these patients reflected no difference in response to either estramustine phosphate (Emcyt) or flutamide. Toxicities were minimal, and the observed survival and progression-free survival intervals were noteworthy in view of the overall prospects for such patients. Future studies dealing with specific quality of life issues seem to be indicated by our results.
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PMID:Comparison of flutamide and Emcyt in hormone-refractory metastatic prostatic cancer. 328 65

From July, 1980, to June, 1983, 319 patients with newly diagnosed metastatic prostatic cancer were randomized to one of three treatment protocols: diethylstilbestrol (DES) or bilateral orchiectomy, cyclophosphamide plus 5-fluorouracil plus DES, and estramustine phosphate (Emcyt). Ninety-three per cent of 296 patients were eligible for evaluation. This report shows no difference in survival, disease-free progression time, or status regarding pain at entry. Other prognostic factors failed to reveal any difference within any of the treatment protocols.
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PMID:Results of another trial of chemotherapy with and without hormones in patients with newly diagnosed metastatic prostate cancer. 352 38

We have investigated a group of 30 patients with newly diagnosed metastatic carcinoma of the prostate who were randomly assigned to receive, as primary treatment, either diethylstilbestrol (DES) or estramustine phosphate (Emcyt). Clinical response was assessed following the guidelines of the National Prostatic Cancer Project and the Eastern Cooperative Oncology Group. Effective reduction in the levels of androgens was noted in all patients in both groups regardless of response. During the follow-up period (ranging between 2-5 years) relapses were noted despite the presence of androgen levels at or below castrate values. The most relevant endocrine observation was the detection of early elevations in serum prolactin in a majority of patients. It was noted, however, that those patients in whom hyperprolactinemia did not occur or appeared only briefly at the beginning of therapy, experienced a prolonged, symptom-free survival. Persistent hyperprolactinemia, on the other hand, carried an ominous prognosis. The differences in survival between normoprolactinemic and hyperprolactinemic groups carried statistical significance.
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PMID:Clinical relevance of plasma testosterone and prolactin changes in advanced cancer of prostate treated with diethylstilbestrol or estramustine phosphate. 390 34

Experiences resulting from Emcyt therapy in patients with both newly diagnosed and hormone refractory advanced prostate cancer, as well as on adjuvant to surgery or radiotherapy in earlier disease are presented. Data from trials of the National Prostatic Cancer Project (NPCP) and a series from Roswell Park Memorial Institute (RPMI) were divided into short-term (up to twenty weeks and up to fifty-two weeks in adjuvant trials) and long-term therapy. Baseline disease and patient characteristics and toxicities encountered in these two treatment-duration groups were compared. Patients in a more favorable health or disease status and/or responded to therapy were more frequently in the long-term group. Patients in the long-term group tended to have higher over-all incidences of toxicity; and although many had occurrences begin as early as those in the short-term group, they were able to tolerate the therapy for relatively long periods. The agent is thus both effective and can be given safety for long periods of time.
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PMID:Observations of prolonged use of oral Emcyt in prostatic cancer patients. 675 58

The optimal therapy for metastatic prostate cancer that has failed initial hormonal therapy poses a significant dilemma for the attending physician. No salvage therapy has proven to be clearly superior. Currently accepted treatment options range from supportive care alone to highly investigational regimens. Recent encouraging results have been reported with investigational agents such as suramin and R. 75251 (Liarozole), and with novel combinations such as estramustine (Emcyt) plus vinblastine. However, there is still no proof that salvage therapy prolongs survival. In a patient population that is older and frequently debilitated, with an expected median survival of 6 months, determinants of therapy should include drug toxicity profiles, frequency of treatment and follow-up studies, and necessity for hospitalization. For patients with good performance status and organ function, participation in clinical trials should be advocated. Quality-of-life issues should be integrated into all clinical trials involving hormone-refractory metastatic prostate cancer.
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PMID:Treatment of progressive metastatic prostate cancer. 851 79

Between 1984 and 1989, 197 patients with T1-4, NX, M1, G2-3 or G3 prostate cancer were randomized to treatment with 560 mg estramustine phosphate (EMP, Estracyt, Emcyt) or 3 mg diethylstilbestrol (DES) per day in a double blind study with stratification on presence or absence of cancer pain at start. A total of 194 patients were evaluated for efficacy of therapy. Time to progression (p = 0.054), to treatment failure (p = 0.036), cancer-specific survival (p = 0.068) as well as overall survival (p = 0.021) were longer in the DES group. There were more patients with prognostic parameters indicating bad prognosis in the EMP group. This trial was designed to study whether EMP had better effect than DES as the primary treatment of high-grade, disseminated prostate cancer. The results did not confirm this hypothesis. On the contrary, treatment with DES had relatively good effect on this very aggressive form of prostate cancer.
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PMID:Treatment of high-grade, high-stage prostate cancer with estramustine phosphate or diethylstilbestrol. A double-blind study. The SPCG-1 Study Group. Scandinavian Prostate Cancer Group. 916 81

Angiogenesis is essential to prostate cancer progression. The first study of antiangiogenic therapy in patients with locally advanced prostate cancer at The University of Texas M. D. Anderson Cancer Center showed that preoperative treatment with a fumagillin analog was safe. Microvascular density correlated with Gleason score, but marked intertumoral and intratumoral changes were observed. Clinical experience with thalidomide (Thalomid), which inhibits angiogenesis induced by both vascular endothelial growth factor and basic fibroblast growth factor, has included observation of "clinical improvement" in patients with androgen-independent prostate cancer and anecdotal responses in patients with metastatic disease refractory to chemotherapy. In an effort to assess the in vivo effect of thalidomide in prostate carcinoma, we have initiated a study of neoadjuvant thalidomide treatment in patients with locally advanced prostate cancer that is to include serial ultrasonographic and pathologic evaluation, as well as serial collection of serum/urine markers that may prove useful surrogate markers of antiangiogenic activity. We have also initiated a phase I/II trial of thalidomide, paclitaxel (Taxol), and estramustine (Emcyt) in patients with metastatic androgen-independent prostate cancer progressing after up to two courses of chemotherapy.
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PMID:Development of angiogenesis inhibition as therapy for prostate cancer. 1120 69

Docetaxel (Taxotere)-based regimens can be included among the most effective treatment options for the management of patients with advanced, androgen-independent prostate cancer. Results with docetaxel as a single agent and in combination regimens with estramustine (Emcyt) have consistently achieved a palliative response, reduced serum PSA levels by > or = 50%, and produced objective responses in patients with measurable disease. In addition, encouraging survival data have been demonstrated in several phase II trials. The ability to administer docetaxel on a weekly basis has substantially enhanced research efforts for treatment in prostate cancer patients. The results of ongoing phase III randomized trials evaluating docetaxel regimens in androgen-independent prostate cancer are eagerly awaited for their potential to definitively demonstrate a beneficial impact on overall patient survival. Docetaxel-containing regimens are likely to demonstrate a substantial role in the management of early-stage prostate cancer patients in the adjuvant and neoadjuvant settings, where clinical investigations are under way. In addition, study results from ongoing trials that integrate docetaxel with hormonal therapies for patients with biochemical recurrence following definitive local treatments will be important in refining the future role of chemotherapy for prostate cancer in general. The preliminary findings from studies conducted with docetaxel are encouraging and await final analysis. Finally, preliminary results from studies exploring combination regimens of docetaxel and novel agents that possess completely different mechanisms of action (eg, proapoptotic agents, angiogenesis inhibitors, and vitamin D analogs) have demonstrated the regimens to be feasible and safe, with promising early response data. These types of investigational studies will likely occupy a dominant position in future research initiatives for patients with advanced prostate cancer.
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PMID:Docetaxel in the integrated management of prostate cancer. Current applications and future promise. 1210 99

Docetaxel (Taxotere) is a taxoid derived from the needles of the European yew tree, Taxus baccata. With an overall prostate-specific antigen response rate of 42% in four Phase II studies, docetaxel has important single-agent activity in androgen-independent prostate cancer. Phase II studies suggest that the addition of estramustine (Emcyt) to docetaxel results in higher response rates but also increased toxicity. Docetaxel with and without estramustine is being evaluated in Phase III studies that will provide definitive information about its role in androgen-independent prostate cancer. Novel combinations of docetaxel with biologic response modifiers are in early stages of development. Similarly, a number of investigators are conducting exploratory trials that incorporate docetaxel into multimodality approaches to high-risk localized prostate cancer treatment.
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PMID:Docetaxel (taxotere) in the treatment of prostate cancer. 1282 Jul 71


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