Is combined andrigen blockade by surgical castration and flutamide necessary as an initial therapy for patients with advanced prostate cancer ? : a randomised clinical trial

Abstract EN

Objective: Prostate cancer incidence and mortality vary widely among countries.

Surgical castration by orchidectomy with or without hormonal therapy is one approach for patients presenting with advanced disease.

The aim of this work was to study the efficacy of surgical castration by orchidectomy alone versus orchidectomy with flutamide, as an initial treatment for patients presenting with advanced carcinoma of prostate.

Methods: This randomized clinical trial included 60 patients presenting with advanced prostatic cancer between 2012 to 2017.

Surgical castration by orchidectomy was done for all patients followed by randomizing them into two groups; group I with surgical castration only and group II with castration plus flutamide therapy.

The patients were followed up for their response rates and survival for the next two years following castration.

Results: The mean percent of change in the values of PSA in the two arms of the study was close.

The patients in the two arms of the trial showed no significant difference regarding their response rate at the end of first two years following orchidectomy.

Conclusions: Initial use of flutamide following orchidectomy seems to add no significant benefit in regard to changes in PSA and the survival in these patients.