Abstract
Purpose
To evaluate the relative efficiency of leuprolide 3.75 mg, leuprolide 7.5 mg, and goserelin 3.6 mg in relation to the reduction in serum testosterone, regarding the levels of castration.
Materials and methods
We evaluated prospectively 60 randomized patients with advanced prostate carcinoma, with indication for hormone blockade. The patients were divided into 3 groups of 20: Group (1) received leuprolide 3.75 mg; Group (2) received leuprolide 7.5 mg; and Group (3) received goserelin 3.6 mg. All groups were treated with monthly application of the respective drugs. The patients’ levels of serum testosterone were evaluated in two moments: before the treatment and 3 months after the treatment.
Results
The patients’ ages were similar within the three groups, with a median of 72, 70, and 70 in groups 1, 2, and 3, respectively. Of the patients that received leuprolide 3.75 mg, leuprolide 7.5 mg, and goserelin 3.6 mg, 26.3, 25, and 35%, respectively, did not reach castration levels, considering a testosterone cutoff ≤ 50 ng/dl. And 68.4, 30, and 45%, respectively, did not reach castration levels, considering a testosterone cutoff ≤ 20 ng/dl.
Conclusions
There were no statistically significant differences in the levels of castration when comparing leuprolide 3.75 mg, leuprolide 7.5 mg, and goserelin 3.6 mg, altogether. When compared in groups of two, there was a statistically significant difference between leuprolide 3.75 mg and leuprolide 7.5 mg, the latter presented better results in reaching castration levels, cutoff ≤ 20 ng/dl. The importance of this difference, however, must be measured with caution, since the comparison of the three groups simultaneously did not reach the established significance level, even though it came close.
Similar content being viewed by others
References
INCA (2009) Câncer no Brasil—Dados dos Registros de Base Populacional
Seidenfeld J, Samson DJ, Aronson N, Albertson PC, Bayoumi AM, Bennett C, et al. (2009) Relative effectiveness and cost-effectiveness of methods of androgen suppression in the treatment of advanced prostate cancer. Evid Rep Technol Assess (Summ) 4(i-x):1–246, 11–36, passim
Cooper AP (1836) The principles and practice of surgery. Cox, London
Beatson GT (1896) On the treatment of inoperable cases of carcinoma of the mamma: suggestions for a new method of treatment with illustrative cases. Lancet 148(3803):162–165
Huggins C, Stevens RE Jr, Hodges CV (1941) Studies on prostatic cancer: II. The effect of castration on advanced cancer of the prostate gland. Arch Surg 43:209–223
Denis L, Murphy GP (1993) Overview of phase III trials on combined androgen treatment in patients with metastatic prostate cancer. Cancer 72(12 suppl):3888–3895
Hellerstedt BA, Pienta KJ (2002) The current state of hormonal therapy for prostate cancer. CA Cancer J Clin 52(3):154–179
Zhang XZ, Donovan MP, Williams BT, Mohleer JL (1996) Comparison of subcapsular and total orchiectomy for treatment of metastatic prostate cancer. Urology 47(3):402–404
Chapman FP (1987) Comparison of testosterone and LH values in subcapsular vs total orchiectomy patients. Urology 30(1):27–28
Yasumoto R, Nishisaka N, Maekawa T, Kawashima H, Kawano M, Kyo M, Turusaki K (1998) Subcapsular orchiectomy using ultrasonic surgical aspirator for testicular androgen ablation: a new alternative technique and long term follow-up. Minim Invasive Ther Allied Technol 7(4):385–387
National Comprehensive Cancer Network: prostate cancer (2011) NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Version 1
Reis LO (2011) Old issues and new perspectives on prostate cancer hormonal therapy: the molecular substratum. Med Oncol. doi:10.1007/s12032-011-9991-z
Peres-Marreno R, Chu FM, Gleason D, Loizides E, Wachs B, Tyler RC (2002) A six-month, open-label study assessing a new formulation of leuprolide 7,5 mg for suppression of testosterone in patients with prostate câncer. Clin Therap 24(11):1902–1914
Novara G, Galfano A, Secco S, Ficarra V, Artibani W (2009) Impact of surgical and medical castration on serum testosterone level in prostate câncer patients. Urol Int 82:249–255
Novara G, Galfano A, Secco S, Ficarra V, Artibani W (2009) Impact of surgical and medical castration on serum testosterone level in prostate câncer patients. Urol Int 82:249–255
Rohl HF, Beuke HP (1992) Effect of orchidectomy on serum concentration of testosterone and dihydrotestosterone in patients with prostatic câncer. Scand J Urol Nephrol 26:11–14
Oefelein MG, Feng A, Scolieri MJ, Ricchiutti D, Resnick MI (2000) Reassessment of the definition of castrate levels of testosterone: implications for clinical decision making. Urology 56:1021–1024
Oefelein MG, Cornum R (2000) Failure to achieve castrate levels of testosterone during luteinizing hormone releasing hormone agonist therapy: the case for monitoring serum testosterone and a treatment decision algorithm. J Urol 164:726–729
Tombal B (2005) Appropriate castration with luteinising hormone releasing hormone (LHRH) agonists: what is the optimal level of testosterone? Eur Urol Suppl 4:14–19
Esquena S, Abascal JM, Trilla E, Morote J (2004) Failure of luteinizing hormone releasing hormone agonist therapy to achieve castration. Does it exist? Eur Urol (Suppl 3):57
Prostate Cancer Trialists’ Collaborative Group (2000) Maximum androgen blockade in advanced prostate cancer: an overview of the randomised trials. Lancet 355:1491–1498
Schmitt B, Bennett C, Seidenfeld J, Samson D, Wilt T (2010) Maximal androgen blockade for advanced prostate cancer. Cochrane Database Syst Rev (Issue 12)
Conflict of interest
The authors have declared that no conflict of interest exists.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Silva, É.D., Ferreira, U., Matheus, W. et al. Goserelin versus leuprolide in the chemical castration of patients with prostate cancer. Int Urol Nephrol 44, 1039–1044 (2012). https://doi.org/10.1007/s11255-012-0134-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-012-0134-z