[Antiandrogen suppression syndrome in patients with hormone-resistant cancer of the prostate].

OBJECTIVE

To analyze the evolution of serum prostate specific antigen (PSA) levels and the clinical response following the suppression of the antiandrogen in patients with metastatic prostate cancer who undergo complete androgen blockade in a hormone refractory status.

MATERIAL AND METHODS

19 patients were evaluated. Following flutamide suppression, their PSA serum levels were measured monthly and the subjective clinical response assessed. Additionally, the objective clinical response was also assessed at three months.

RESULTS

In 11 patients (57.9%), PSA serum concentration continued to increase and no clinical response was seen in any of them. In the 8 remaining cases (42.1%) there was a decrease in PSA serum levels ranging between 2.1 and 84.5%; this decrease was greater than 50% in 5 patients (26.3%). Mean duration of the biochemical response was 4.5 months (2-11). Subjective clinical responses were reported in 5 patients (26.2%), while an objective clinical response was seen in 2 (10.5%) cases who had PSA reductions greater than 50% and were maintained for periods of over 6 months.

CONCLUSIONS

Antiandrogen suppression in patients with hormone refractory prostate cancer with complete hormone blockade, can result in considerable albeit short biochemical and clinical responses. For this reason, this should be considered as the first therapeutical approach, whereas in responder patients any other second line treatment could be delayed until a new PSA increase or symptomatic worsening is detected.