Intermittent hormonal therapy in the treatment of metastatic prostate cancer: a randomized trial
Study Type – Therapy (RCT) Level of Evidence 1b What's known on the subject? and What does the study add? Intermittent androgen deprivation therapy (ADT) involves cycling ADT, allowing hormonal recovery during off‐treatment periods. This could lead to a better quality of life during off‐treatme...
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| Veröffentlicht in: | BJU international 2012-11, Vol.110 (9), p.1262-1269 |
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| creator | Mottet, Nicolas Van Damme, Jean Loulidi, Salim Russel, Christoph Leitenberger, Armin Wolff, Johannes M. |
| description | Study Type – Therapy (RCT)
Level of Evidence 1b
What's known on the subject? and What does the study add?
Intermittent androgen deprivation therapy (ADT) involves cycling ADT, allowing hormonal recovery during off‐treatment periods. This could lead to a better quality of life during off‐treatment periods and could delay progression to castration resistance. Safety and feasibility of intermittent ADT have been shown but tolerability and health‐related quality of life improvement have been suggested but questioned by others. Results from randomized trials, including relapsing or mixed populations, have suggested intermittent ADT to be as effective as continuous ADT.
In this study of only metastatic patients, no statistical difference in either overall survival or progression‐free survival was shown between intermittent and continuous ADT and suggests that intermittent might be as safe as continuous castration. It could be an option in highly responding and well‐informed metastatic patients even if no clear benefit in health‐related quality of life was shown. This intermittent modality could be of interest in metastatic patients with significant treatment‐induced side‐effects.
OBJECTIVE
•
To compare intermittent androgen deprivation therapy (ADT) and continuous ADT after 6 months of induction of ADT in patients with metastatic prostate cancer (PCa).
PATIENTS AND METHODS
•
This is an open‐label randomized multi‐centre study conducted in 58 centres in Europe.
•
Patients with metastatic PCa and prostate‐specific antigen (PSA) level >20 ng/mL at selection were randomized after 6 months of induction of ADT (leuprorelin and flutamide) if PSA level had decreased below 4 ng/mL.
•
Patients received either continuous or intermittent ADT. All patients were treated until signs of disease progression under treatment or until study end with a monthly central PSA determination and follow‐up visits were performed every 3 months.
•
The primary endpoint was overall survival. Secondary endpoints included progression‐free survival, health‐related quality of life (QLQ C30 questionnaire) and safety criteria.
RESULTS
•
Of 383 selected patients, 173 had a PSA level below 4 ng/mL after 6 months of induction of ADT and were randomized. Median overall survival (52 vs 42 months, P= 0.75) and median progression‐free survival (15.1 vs 20.7 months, P= 0.74) were not significantly different between continuous and intermittent ADT.
•
Although some differences in quality of life were o |
| doi_str_mv | 10.1111/j.1464-410X.2012.11120.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1237511548</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1237511548</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5440-8607913f0c303c22c763c943bb359e1baf9cf60d74817af3a20748c7780270c13</originalsourceid><addsrcrecordid>eNqNkU1LAzEQhoMofv8FCYjgpXWS7GZ3PQgqfiJ4UfAWp2kWU_ajJilaf72JrQqezCUvk2cmM-8QQhkMWTxHkyHLZDbIGDwNOTCeohyG7ytk8-dh9VtDJTfIlvcTgBiQ-TrZ4DwHXjK5SZ5vumBca0MwXaAvvWv7DhsaXozD6ZzaLkkanMHQJqKvaWsC-oDBajp1fVKGauy0cccUqcNu3Lf2w4xjlsVmh6zV2Hizu7y3yePlxcP59eDu_urm_PRuoPMsg0EpoaiYqEELEJpzXUihq0yMRiKvDBthXelawrjISlZgLZBDlLooSuAFaCa2yeGibuzpdWZ8UK312jQNdqafecW4KHLG8qyM6P4fdNLPXBw7UiIXQjLOE1UuKB2H9M7Uaupsi26uGKi0BTVRyWCVzFZpC-prC-o9pu4tP5iNWjP-Sfy2PQIHSwC9xqaOpmnrfzmZy6os01AnC-7NNmb-7wbU2e3jlxSf452iHA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1353361228</pqid></control><display><type>article</type><title>Intermittent hormonal therapy in the treatment of metastatic prostate cancer: a randomized trial</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Mottet, Nicolas ; Van Damme, Jean ; Loulidi, Salim ; Russel, Christoph ; Leitenberger, Armin ; Wolff, Johannes M.</creator><creatorcontrib>Mottet, Nicolas ; Van Damme, Jean ; Loulidi, Salim ; Russel, Christoph ; Leitenberger, Armin ; Wolff, Johannes M. ; TAP22 Investigators Group ; the TAP22 Investigators Group</creatorcontrib><description>Study Type – Therapy (RCT)
Level of Evidence 1b
What's known on the subject? and What does the study add?
Intermittent androgen deprivation therapy (ADT) involves cycling ADT, allowing hormonal recovery during off‐treatment periods. This could lead to a better quality of life during off‐treatment periods and could delay progression to castration resistance. Safety and feasibility of intermittent ADT have been shown but tolerability and health‐related quality of life improvement have been suggested but questioned by others. Results from randomized trials, including relapsing or mixed populations, have suggested intermittent ADT to be as effective as continuous ADT.
In this study of only metastatic patients, no statistical difference in either overall survival or progression‐free survival was shown between intermittent and continuous ADT and suggests that intermittent might be as safe as continuous castration. It could be an option in highly responding and well‐informed metastatic patients even if no clear benefit in health‐related quality of life was shown. This intermittent modality could be of interest in metastatic patients with significant treatment‐induced side‐effects.
OBJECTIVE
•
To compare intermittent androgen deprivation therapy (ADT) and continuous ADT after 6 months of induction of ADT in patients with metastatic prostate cancer (PCa).
PATIENTS AND METHODS
•
This is an open‐label randomized multi‐centre study conducted in 58 centres in Europe.
•
Patients with metastatic PCa and prostate‐specific antigen (PSA) level >20 ng/mL at selection were randomized after 6 months of induction of ADT (leuprorelin and flutamide) if PSA level had decreased below 4 ng/mL.
•
Patients received either continuous or intermittent ADT. All patients were treated until signs of disease progression under treatment or until study end with a monthly central PSA determination and follow‐up visits were performed every 3 months.
•
The primary endpoint was overall survival. Secondary endpoints included progression‐free survival, health‐related quality of life (QLQ C30 questionnaire) and safety criteria.
RESULTS
•
Of 383 selected patients, 173 had a PSA level below 4 ng/mL after 6 months of induction of ADT and were randomized. Median overall survival (52 vs 42 months, P= 0.75) and median progression‐free survival (15.1 vs 20.7 months, P= 0.74) were not significantly different between continuous and intermittent ADT.
•
Although some differences in quality of life were observed, most of the functional and symptom scales showed no significant difference between the two groups.
•
Significantly fewer treatment–emergent adverse events occurred in the intermittent group (P= 0.042), with the incidence of headache and hot flushes also lower.
CONCLUSIONS
•
This first randomized trial comparing continuous with intermittent ADT in metastatic PCa suggests that intermittent ADT might be as safe as continuous ADT.
•
It could be an option in highly responding and well‐informed patients even if no clear benefit in health‐related quality of life was shown.</description><identifier>ISSN: 1464-4096</identifier><identifier>EISSN: 1464-410X</identifier><identifier>DOI: 10.1111/j.1464-410X.2012.11120.x</identifier><identifier>PMID: 22502816</identifier><identifier>CODEN: BJINFO</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Administration, Cutaneous ; Administration, Oral ; Aged ; Androgen Antagonists - administration & dosage ; Antineoplastic Agents, Hormonal - administration & dosage ; Biological and medical sciences ; Disease-Free Survival ; Drug Administration Schedule ; Flutamide - administration & dosage ; Gynecology. Andrology. Obstetrics ; hormonal therapy ; Humans ; intermittent therapy ; Kaplan-Meier Estimate ; Leuprolide - administration & dosage ; Male ; Male genital diseases ; Medical sciences ; metastatic prostate cancer ; Nephrology. Urinary tract diseases ; Ovarian cancer ; Prospective Studies ; Prostate cancer ; Prostatic Neoplasms - drug therapy ; Prostatic Neoplasms - mortality ; Quality of life ; Tablets ; Treatment Outcome ; Tumors ; Tumors of the urinary system ; Urinary tract. Prostate gland</subject><ispartof>BJU international, 2012-11, Vol.110 (9), p.1262-1269</ispartof><rights>2012 THE AUTHORS. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL</rights><rights>2015 INIST-CNRS</rights><rights>2012 THE AUTHORS. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.</rights><rights>BJUI © 2012 BJU International</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5440-8607913f0c303c22c763c943bb359e1baf9cf60d74817af3a20748c7780270c13</citedby><cites>FETCH-LOGICAL-c5440-8607913f0c303c22c763c943bb359e1baf9cf60d74817af3a20748c7780270c13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1464-410X.2012.11120.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1464-410X.2012.11120.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26569881$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22502816$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mottet, Nicolas</creatorcontrib><creatorcontrib>Van Damme, Jean</creatorcontrib><creatorcontrib>Loulidi, Salim</creatorcontrib><creatorcontrib>Russel, Christoph</creatorcontrib><creatorcontrib>Leitenberger, Armin</creatorcontrib><creatorcontrib>Wolff, Johannes M.</creatorcontrib><creatorcontrib>TAP22 Investigators Group</creatorcontrib><creatorcontrib>the TAP22 Investigators Group</creatorcontrib><title>Intermittent hormonal therapy in the treatment of metastatic prostate cancer: a randomized trial</title><title>BJU international</title><addtitle>BJU Int</addtitle><description>Study Type – Therapy (RCT)
Level of Evidence 1b
What's known on the subject? and What does the study add?
Intermittent androgen deprivation therapy (ADT) involves cycling ADT, allowing hormonal recovery during off‐treatment periods. This could lead to a better quality of life during off‐treatment periods and could delay progression to castration resistance. Safety and feasibility of intermittent ADT have been shown but tolerability and health‐related quality of life improvement have been suggested but questioned by others. Results from randomized trials, including relapsing or mixed populations, have suggested intermittent ADT to be as effective as continuous ADT.
In this study of only metastatic patients, no statistical difference in either overall survival or progression‐free survival was shown between intermittent and continuous ADT and suggests that intermittent might be as safe as continuous castration. It could be an option in highly responding and well‐informed metastatic patients even if no clear benefit in health‐related quality of life was shown. This intermittent modality could be of interest in metastatic patients with significant treatment‐induced side‐effects.
OBJECTIVE
•
To compare intermittent androgen deprivation therapy (ADT) and continuous ADT after 6 months of induction of ADT in patients with metastatic prostate cancer (PCa).
PATIENTS AND METHODS
•
This is an open‐label randomized multi‐centre study conducted in 58 centres in Europe.
•
Patients with metastatic PCa and prostate‐specific antigen (PSA) level >20 ng/mL at selection were randomized after 6 months of induction of ADT (leuprorelin and flutamide) if PSA level had decreased below 4 ng/mL.
•
Patients received either continuous or intermittent ADT. All patients were treated until signs of disease progression under treatment or until study end with a monthly central PSA determination and follow‐up visits were performed every 3 months.
•
The primary endpoint was overall survival. Secondary endpoints included progression‐free survival, health‐related quality of life (QLQ C30 questionnaire) and safety criteria.
RESULTS
•
Of 383 selected patients, 173 had a PSA level below 4 ng/mL after 6 months of induction of ADT and were randomized. Median overall survival (52 vs 42 months, P= 0.75) and median progression‐free survival (15.1 vs 20.7 months, P= 0.74) were not significantly different between continuous and intermittent ADT.
•
Although some differences in quality of life were observed, most of the functional and symptom scales showed no significant difference between the two groups.
•
Significantly fewer treatment–emergent adverse events occurred in the intermittent group (P= 0.042), with the incidence of headache and hot flushes also lower.
CONCLUSIONS
•
This first randomized trial comparing continuous with intermittent ADT in metastatic PCa suggests that intermittent ADT might be as safe as continuous ADT.
•
It could be an option in highly responding and well‐informed patients even if no clear benefit in health‐related quality of life was shown.</description><subject>Administration, Cutaneous</subject><subject>Administration, Oral</subject><subject>Aged</subject><subject>Androgen Antagonists - administration & dosage</subject><subject>Antineoplastic Agents, Hormonal - administration & dosage</subject><subject>Biological and medical sciences</subject><subject>Disease-Free Survival</subject><subject>Drug Administration Schedule</subject><subject>Flutamide - administration & dosage</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>hormonal therapy</subject><subject>Humans</subject><subject>intermittent therapy</subject><subject>Kaplan-Meier Estimate</subject><subject>Leuprolide - administration & dosage</subject><subject>Male</subject><subject>Male genital diseases</subject><subject>Medical sciences</subject><subject>metastatic prostate cancer</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Ovarian cancer</subject><subject>Prospective Studies</subject><subject>Prostate cancer</subject><subject>Prostatic Neoplasms - drug therapy</subject><subject>Prostatic Neoplasms - mortality</subject><subject>Quality of life</subject><subject>Tablets</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Tumors of the urinary system</subject><subject>Urinary tract. Prostate gland</subject><issn>1464-4096</issn><issn>1464-410X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU1LAzEQhoMofv8FCYjgpXWS7GZ3PQgqfiJ4UfAWp2kWU_ajJilaf72JrQqezCUvk2cmM-8QQhkMWTxHkyHLZDbIGDwNOTCeohyG7ytk8-dh9VtDJTfIlvcTgBiQ-TrZ4DwHXjK5SZ5vumBca0MwXaAvvWv7DhsaXozD6ZzaLkkanMHQJqKvaWsC-oDBajp1fVKGauy0cccUqcNu3Lf2w4xjlsVmh6zV2Hizu7y3yePlxcP59eDu_urm_PRuoPMsg0EpoaiYqEELEJpzXUihq0yMRiKvDBthXelawrjISlZgLZBDlLooSuAFaCa2yeGibuzpdWZ8UK312jQNdqafecW4KHLG8qyM6P4fdNLPXBw7UiIXQjLOE1UuKB2H9M7Uaupsi26uGKi0BTVRyWCVzFZpC-prC-o9pu4tP5iNWjP-Sfy2PQIHSwC9xqaOpmnrfzmZy6os01AnC-7NNmb-7wbU2e3jlxSf452iHA</recordid><startdate>201211</startdate><enddate>201211</enddate><creator>Mottet, Nicolas</creator><creator>Van Damme, Jean</creator><creator>Loulidi, Salim</creator><creator>Russel, Christoph</creator><creator>Leitenberger, Armin</creator><creator>Wolff, Johannes M.</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope></search><sort><creationdate>201211</creationdate><title>Intermittent hormonal therapy in the treatment of metastatic prostate cancer: a randomized trial</title><author>Mottet, Nicolas ; Van Damme, Jean ; Loulidi, Salim ; Russel, Christoph ; Leitenberger, Armin ; Wolff, Johannes M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5440-8607913f0c303c22c763c943bb359e1baf9cf60d74817af3a20748c7780270c13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Administration, Cutaneous</topic><topic>Administration, Oral</topic><topic>Aged</topic><topic>Androgen Antagonists - administration & dosage</topic><topic>Antineoplastic Agents, Hormonal - administration & dosage</topic><topic>Biological and medical sciences</topic><topic>Disease-Free Survival</topic><topic>Drug Administration Schedule</topic><topic>Flutamide - administration & dosage</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>hormonal therapy</topic><topic>Humans</topic><topic>intermittent therapy</topic><topic>Kaplan-Meier Estimate</topic><topic>Leuprolide - administration & dosage</topic><topic>Male</topic><topic>Male genital diseases</topic><topic>Medical sciences</topic><topic>metastatic prostate cancer</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Ovarian cancer</topic><topic>Prospective Studies</topic><topic>Prostate cancer</topic><topic>Prostatic Neoplasms - drug therapy</topic><topic>Prostatic Neoplasms - mortality</topic><topic>Quality of life</topic><topic>Tablets</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Tumors of the urinary system</topic><topic>Urinary tract. Prostate gland</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mottet, Nicolas</creatorcontrib><creatorcontrib>Van Damme, Jean</creatorcontrib><creatorcontrib>Loulidi, Salim</creatorcontrib><creatorcontrib>Russel, Christoph</creatorcontrib><creatorcontrib>Leitenberger, Armin</creatorcontrib><creatorcontrib>Wolff, Johannes M.</creatorcontrib><creatorcontrib>TAP22 Investigators Group</creatorcontrib><creatorcontrib>the TAP22 Investigators Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>BJU international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mottet, Nicolas</au><au>Van Damme, Jean</au><au>Loulidi, Salim</au><au>Russel, Christoph</au><au>Leitenberger, Armin</au><au>Wolff, Johannes M.</au><aucorp>TAP22 Investigators Group</aucorp><aucorp>the TAP22 Investigators Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intermittent hormonal therapy in the treatment of metastatic prostate cancer: a randomized trial</atitle><jtitle>BJU international</jtitle><addtitle>BJU Int</addtitle><date>2012-11</date><risdate>2012</risdate><volume>110</volume><issue>9</issue><spage>1262</spage><epage>1269</epage><pages>1262-1269</pages><issn>1464-4096</issn><eissn>1464-410X</eissn><coden>BJINFO</coden><abstract>Study Type – Therapy (RCT)
Level of Evidence 1b
What's known on the subject? and What does the study add?
Intermittent androgen deprivation therapy (ADT) involves cycling ADT, allowing hormonal recovery during off‐treatment periods. This could lead to a better quality of life during off‐treatment periods and could delay progression to castration resistance. Safety and feasibility of intermittent ADT have been shown but tolerability and health‐related quality of life improvement have been suggested but questioned by others. Results from randomized trials, including relapsing or mixed populations, have suggested intermittent ADT to be as effective as continuous ADT.
In this study of only metastatic patients, no statistical difference in either overall survival or progression‐free survival was shown between intermittent and continuous ADT and suggests that intermittent might be as safe as continuous castration. It could be an option in highly responding and well‐informed metastatic patients even if no clear benefit in health‐related quality of life was shown. This intermittent modality could be of interest in metastatic patients with significant treatment‐induced side‐effects.
OBJECTIVE
•
To compare intermittent androgen deprivation therapy (ADT) and continuous ADT after 6 months of induction of ADT in patients with metastatic prostate cancer (PCa).
PATIENTS AND METHODS
•
This is an open‐label randomized multi‐centre study conducted in 58 centres in Europe.
•
Patients with metastatic PCa and prostate‐specific antigen (PSA) level >20 ng/mL at selection were randomized after 6 months of induction of ADT (leuprorelin and flutamide) if PSA level had decreased below 4 ng/mL.
•
Patients received either continuous or intermittent ADT. All patients were treated until signs of disease progression under treatment or until study end with a monthly central PSA determination and follow‐up visits were performed every 3 months.
•
The primary endpoint was overall survival. Secondary endpoints included progression‐free survival, health‐related quality of life (QLQ C30 questionnaire) and safety criteria.
RESULTS
•
Of 383 selected patients, 173 had a PSA level below 4 ng/mL after 6 months of induction of ADT and were randomized. Median overall survival (52 vs 42 months, P= 0.75) and median progression‐free survival (15.1 vs 20.7 months, P= 0.74) were not significantly different between continuous and intermittent ADT.
•
Although some differences in quality of life were observed, most of the functional and symptom scales showed no significant difference between the two groups.
•
Significantly fewer treatment–emergent adverse events occurred in the intermittent group (P= 0.042), with the incidence of headache and hot flushes also lower.
CONCLUSIONS
•
This first randomized trial comparing continuous with intermittent ADT in metastatic PCa suggests that intermittent ADT might be as safe as continuous ADT.
•
It could be an option in highly responding and well‐informed patients even if no clear benefit in health‐related quality of life was shown.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>22502816</pmid><doi>10.1111/j.1464-410X.2012.11120.x</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1464-4096 |
| ispartof | BJU international, 2012-11, Vol.110 (9), p.1262-1269 |
| issn | 1464-4096 1464-410X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1237511548 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Administration, Cutaneous Administration, Oral Aged Androgen Antagonists - administration & dosage Antineoplastic Agents, Hormonal - administration & dosage Biological and medical sciences Disease-Free Survival Drug Administration Schedule Flutamide - administration & dosage Gynecology. Andrology. Obstetrics hormonal therapy Humans intermittent therapy Kaplan-Meier Estimate Leuprolide - administration & dosage Male Male genital diseases Medical sciences metastatic prostate cancer Nephrology. Urinary tract diseases Ovarian cancer Prospective Studies Prostate cancer Prostatic Neoplasms - drug therapy Prostatic Neoplasms - mortality Quality of life Tablets Treatment Outcome Tumors Tumors of the urinary system Urinary tract. Prostate gland |
| title | Intermittent hormonal therapy in the treatment of metastatic prostate cancer: a randomized trial |
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