Document Detail


High dose intravenous oestrogen (fosfestrol) in the treatment of symptomatic, metastatic, hormone-refractory carcinoma of the prostate.
MedLine Citation:
PMID:  9607886     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: High dose intravenous stilboestrol has a direct cytotoxic effect on prostatic carcinoma cells. The purpose of this study was to assess subjective and objective responses in a select group of patients with metastatic, hormone-refractory carcinoma of the prostate with severe generalized bone pain in association with symptoms of advanced local disease. PATIENTS AND METHODS: Seventeen patients with metastatic carcinoma of the prostate, who had relapsed following a good initial response to androgen ablation, were treated as inpatients with once daily intravenous injection of 1104 mg diethylstilboestrol diphosphate (Honvan, Asta Medica, Cambridge, UK) for 7 days. The hormone-refractory status was confirmed by castrate serum testosterone levels. All the patients had failed to respond to second-line hormone manipulation and had progressive disease. All the patients had generalized bone pain, 11 also had symptoms of bladder outlet obstruction, 3 had recurrent haematuria and 3 had both. The mean age was 74 years (range 59-83), mean time to chemical relapse (rising PSA) was 29 months (range 1-70), and mean time to clinical relapse was 37 months (range 6-98). The WHO pain score, performance status score, and a patient-specific quality of life (daily living activity) were used as the subjective measures and the serum PSA as an objective marker. All the parameters were recorded before, during and up to three months after treatment. RESULTS: Two patients had a transient relief of bone pain with the pain score reducing by two points. Overall, the pain and performance scores and the local symptoms did not improve. The PSA level continued to rise in all patients. Despite parenteral pre-medication with pethidine and cyclizine, all the patients suffered nausea and pain following the injection. One patient died on the fifth day of treatment from a myocardial infarction and 4 developed deep vein thrombosis. All the patients required further symptom control measures. CONCLUSION: High dose intravenous stilboestrol causes considerable morbidity without any objective or subjective response in the treatment of patients with symptomatic, hormone-refractory metastatic carcinoma of the prostate.
Authors:
M Ahmed; S Choksy; C P Chilton; K W Munson; J H Williams
Related Documents :
19298406 - Prospective comparison of five mediators of the systemic response after high-intensity ...
10026766 - Office treatment of benign prostatic hyperplasia.
7550276 - Balloon dilation of the prostate: correlation with magnetic resonance imaging and trans...
6163206 - Effect of pepleomycin in prostatic cancer. a preliminary report.
16466316 - Parkinson's disease management strategies.
8513736 - Hypertonic saline solution: an effective wound dressing solution.
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  International urology and nephrology     Volume:  30     ISSN:  0301-1623     ISO Abbreviation:  Int Urol Nephrol     Publication Date:  1998  
Date Detail:
Created Date:  1998-07-14     Completed Date:  1998-07-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0262521     Medline TA:  Int Urol Nephrol     Country:  HUNGARY    
Other Details:
Languages:  eng     Pagination:  159-64     Citation Subset:  IM    
Affiliation:
Derby City Hospital, United Kingdom.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Antineoplastic Agents / administration & dosage*,  adverse effects
Carcinoma / drug therapy*,  mortality
Diethylstilbestrol / administration & dosage,  adverse effects,  analogs & derivatives*
Humans
Injections, Intravenous
Male
Middle Aged
Nausea / chemically induced
Pain / prevention & control
Prostatic Neoplasms / drug therapy*,  mortality
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 13425-53-1/fosfestrol; 56-53-1/Diethylstilbestrol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Ceramic coagulation tip for interstitial thermoablation of the prostate: first experiments.
Next Document:  The effects of extensive vas mobilization on testicular histology during orchiopexy.