[Clinical protocols in treatment of prostatic carcinoma in Europe. The role of EORTC and other organizations].

In the last few years the EORTC has conducted multiple clinical studies on the therapy of prostate cancer. In most cases with incidental unifocal prostate cancer, no therapy is necessary, as the disease is rarely progressive or the cause of death. Current EORTC studies are evaluating the timing of hormone therapy, as it is still unknown whether therapy should be started at the time of diagnosis or when the patient becomes symptomatic. Different hormone therapies are useful for locally progressive prostate cancer and as effective than radiotherapy in the case of progression and survival. The preliminary results of a current study on total androgen blockade for 3 months before radical prostatectomy show a positive effect for some of the patients with a T2 carcinoma. Inconclusive results in studies on total androgen blockade versus orchiectomy in metastasising prostate cancer have lead to a meta-analysis of 22 studies by the EORTC. This only showed a trend towards better survival time and longer interval till progression with total androgen blockade but the group of patients with small volume metastatic disease benefit greatly from this treatment. The importance of estrogen therapy and the treatment with high dose non steroidal antiandrogens as well as the use of intermittent hormonal therapy in progressive disease will have to be assessed in future studies. Chemotherapy is not very effective due to its low response rate and its short lived effect.