Early combined hormonal and chemotherapy for metastatic carcinoma of prostate.

Twenty-five patients with confirmed Stage D carcinoma of the prostate were treated by a combination of bilateral orchiectomy, estrogen, and chemotherapy soon after diagnosis was established. Patients were given diethylstilbestrol (DES) 3 mg. daily, and a weekly intravenous injection of 5-fluorouracil (5-FU) 10 mg./Kg. and cyclophosphamide 10 mg./Kg. They were followed up for between sixteen and forty-two months. The majority of patients reported a subjective improvement. Objectively, the primary tumor shrunk by more than 50 per cent in 84 per cent of the patients, while in 64 per cent there was improvement in the lesions shown on bone scan. The cumulative survival rate during three and one-half years was 76.5 per cent. These encouraging preliminary results appear to justify the early initiation of combined therapy in larger numbers of patients with Stage D prostatic carcinoma.