 |
 |
|
Home |
Current Issue |
Past Issues |
In the Clinic |
ACP Journal Club |
CME |
Collections |
Audio/Video |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||
15 November 1993 | Volume 119 Issue 10 | Pages 1054-1055
Dr. Garnick discussed the early treatment of metastatic prostate cancer, total androgen blockade, and the cost of 1 year of flutamide therapy. He stated that 165 000 new cases of prostate cancer are expected to be diagnosed in the United States in 1993, with 25% of patients presenting with stage D2 disease. The early use of total androgen blockade is gaining widespread acceptance in such patients, but it should be noted that the use of flutamide for 1 year as part of total androgen blockade will cost more than 100 million dollars in this country alone. Unfortunately, the therapeutic advantage achieved with total androgen blockade compared with hormonal monotherapy is marginal at best ([1-6] Table 1, and neither form of treatment is curative. Whether the use of flutamide as part of total androgen blockade is justified in all patients with stage D2 prostate cancer or should be restricted by the enforcement of rigid guidelines will require carefully conducted randomized studies. LETTER
Cost-effectiveness of Prostate Cancer Screening and Treatment
TO THE EDITOR:
|
References
|
|---|
 Top References |
|---|
1. Crawford ED, Eisenberger MA, McLeod DG, Spaulding JT, Benson R, Dorr FA, et al. A controlled trial of leuprolide with and without flutamide in prostatic carcinoma. N Engl J Med. 1989; 321:419-24.
2. Keuppens F, Denis L, Smith P, Carval HO AP, Newling D, Bond A, et al. Zoladex and flutamide versus bilateral orchiectomy. A randomized phase III EORTC 30853 study. Cancer. 1990; 66:1045-57.
3. Iversen P, Christensen MG, Friis E, Hornbol P, Hvidt V, Iversen HG, et al. A phase III trial of zoladex and flutamide versus orchiectomy in the treatment of patients with advanced carcinoma of the prostate. Cancer. 1990; 66:1058-66.
4. Beland G, Elhilali M, Fradet Y, Laroche B, Ramsey EW, Trachtenberg J, et al. A controlled trial of castration with and without nilutamide in metastatic prostatic carcinoma. Cancer. 1990; 66:1074-9.
5. Lunglmayr G. A multicenter trial comparing the luteinizing hormone releasing hormone analog zoladex, with zoladex plus flutamide in the treatment of advanced prostate cancer. Eur Urol. 1990; 18(Suppl 3):28-9.
6. Janknegt RA, Abbou CC, Bartoletti R, Bernstein-Hahn L, Bracken B, Brisset JM, et al. Orchiectomy and nilutamide or placebo as treatment of metastatic prostatic cancer in a multinational double-blind randomized trial. J Urol. 1993; 149:77-83.
About Letters
 |
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Article
